Clinical characteristics and economic burden of hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease in the Chinese Yi population

中国彝族人群慢性阻塞性肺疾病急性加重住院患者的临床特征和经济负担

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Abstract

PURPOSE: The study aimed to compare the clinical characteristics and economic burden of Yi and Han hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). PATIENTS AND METHODS: The patients hospitalized for AECOPD were retrospectively enrolled at the Hospital of Integrated Traditional and Western Medicine in Liangshan Yi Autonomous Prefecture, China, from January 2020 to October 2022. Data regarding the characteristics, treatment, clinical outcomes, and economic burden of Yi and Han AECOPD patients included in the cohort were compared and analyzed. Propensity score matching (PSM) adjusted for age and gender differences was used to assess differences between the two groups. RESULTS: Among 685 patients (297 Yi, 388 Han), smoking prevalence was similar (Yi 57.6% vs. Han 55.9%, P > 0.05). Yi patients were significantly younger (66.3 ± 11.0 vs. 76.2 ± 9.9 years, P < 0.001) with more females (36.4% vs. 27.8%, P = 0.017). After PSM, Yi patients showed: (1) lower comorbidity rates (coronary heart disease, hypertension, diabetes, and atrial fibrillation); (2) distinct laboratory profiles (higher hemoglobin, platelets, low-density lipoprotein cholesterol; lower D-dimer, PaO(2), and albumin); (3) reduced intensive care unit (ICU) transfers (P < 0.05) and non-invasive ventilation use (P < 0.05); and (4) more frequent pulmonary infections (45.1% vs. 35.8%, P = 0.014) in unmatched analysis. CONCLUSION: Significant ethnic differences exist in AECOPD presentation and management between Yi and Han populations, independent of age and gender. These findings highlight the need for ethnicity-tailored COPD management strategies in multi-ethnic regions.

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