Abstract Rationale Global healthcare burden of Chronic Obstructive Pulmonary Disease (COPD) is enormous. COPD is responsible for 1.32 million ED visits and 536,000 hospitalizations annually. Failure to identify, treat, and prevent acute exacerbations of COPD (AECOPD), especially those requiring hospitalization, is linked to poorer quality of life, higher mortality, and a faster decline in lung function. Bacterial infections cause approximately 50% of AECOPD, but routine sputum culture collection is not commonplace. Recurrent AECOPD can lead to frequent visits and even hospitalization, which contributes to the substantial healthcare costs and morbidity of COPD. This study aims to characterize the population afflicted by recurrent AECOPD and the role sputum cultures can play in their management. Methods This retrospective, case-control study examined adult patients aged ≥40 years within our local Veterans Affairs institution who had a ‘Problem List’ diagnosis of COPD and who experienced an AECOPD (inpatient or outpatient) from 01/01/2023 to 12/31/2024. Patients were identified using diagnostic codes such as J44.1 AECOPD using TheraDoc. Data was abstracted from CPRS: demographic information, encounter characteristics, and review of encounters up to one year following index AECOPD encounter. Recurrent AECOPD was defined as an AECOPD greater than 14 days from and within one year of index AECOPD. Data were analyzed using SPSS. Results 73 patient encounters were identified involving 40 unique patients. The average patient had 1.3 AECOPD events in the year preceding the encounter. Ten patient encounters had sputum cultures collected at AECOPD diagnosis; 80% of those were inpatient encounters. 50% of sputum cultures were positive. Recurrent AECOPD incidence across all encounters was 50.7%. Rates of recurrence in groups with and without sputum cultures were 70% and 47%, respectively. 20% of positive sputum cultures changed management. Patients in the with versus without sputum culture groups had 2.1 and 1.2 AECOPD events in the preceding year. Conclusion Overall sputum sample use was low in this pilot study; it was higher in inpatient encounters and for patients with more symptomatic disease/higher AECOPD burden. Recurrent AECOPD incidence was quite high in this cohort and higher in with-sputum culture encounters likely due to higher severity of underlying COPD in this studied population. Limitations of this pilot study include small sample size and use of patient problem list diagnosis for inclusion criteria. Future directions will include removing problem list use and assessing encounter details further to identify reasons for obtaining and ordering sputum cultures. This abstract is funded by: None
Henderson et al. (Fri,) studied this question.