Abstract
Chronic obstructive pulmonary disease (COPD) is a common respiratory condition with a high comorbidity burden. This study aims to utilize regional administrative health data and employ network analysis to systematically investigate COPD comorbidity patterns across the entire spectrum of chronic diseases. The hospitalization discharge records from all secondary and tertiary hospitals in Sichuan Province, China, from 2015 to 2019 were collected, including 2,004,891 COPD inpatients. We constructed comorbidity networks using the Salton Cosine Index, applied centrality measures to identify central diseases, and the Louvain algorithm to detect clusters. We found that 96.05% of COPD patients had at least one comorbidity, with essential (primary) hypertension (40.30%) being the most prevalent. The comorbidity network identified 11 central diseases including disorders of glycoprotein metabolism as well as gastritis and duodenitis. Sex differences were reflected in the comorbidity relationships of hyperplasia of the prostate in the male network and osteoporosis without pathological fracture in the female network. Urban patients demonstrated higher comorbidity prevalence and exhibited more complex comorbidity relationships compared to rural patients. This study provided a comprehensive understanding of the complex relationships among comorbidities in hospitalized COPD populations, contributing to the advancement of patient-centered care.