Factors Associated with Acute Exacerbations in Non-Smoking Patients with COPD in China: Findings from the Enjoying Breathing Program

<bold>Objective:</bold> This study aimed to examine the factors associated with acute exacerbations in non-smoking patients with COPD in China. <bold>Methods:</bold> This cross-sectional study utilized data from the Enjoying Breathing Program conducted between May 2020 and April 2022. Non-smoking COPD patients from 17 provinces in China were included in the analysis. Univariable and multivariable analyses were employed, adjusting for age, sex, and other predetermined covariates. <bold>Results:</bold> The study comprised 1709 participants with an average age of 66.21 ± 12.51, with 33.2% being male. Among them, 523 patients (30.6%) experienced acute exacerbations necessitating hospitalization. In logistic regression models adjusting for various factors, non-smoking COPD patients exhibited a reduced likelihood of hospitalization for exacerbation (OR=0.62, 95%CI=0.46-0.83). Other significant findings included an increased risk of hospitalization for COPD exacerbation associated with older age (OR=1.049, 95%CI=1.015-1.041), minority status (OR=2.10, 95%CI=1.30-3.39), residing in the east (OR=3.88, 95%CI=2.18-6.88), central south (OR=2.31, 95%CI=1.40-3.83), or west south regions (OR=3.70, 95%CI=2.02-6.77) of China, biomass exposure exceeding 6 months (OR=1.45, 95%CI=1.11-1.13), and a higher CAT score (OR=1.11, 95%CI=1.08-1.13). <bold>Conclusion:</bold> The study provides valuable insights into the factors influencing acute exacerbations in non-smoking COPD patients in China, emphasizing the importance of tailored interventions for prevention and management of exacerbations in this specific population.