Incident loop diuretic-use after COPD hospitalization is associated with increased 1-year mortality and morbidity

<bold>Background:</bold> Loop diuretics (LD) is used in the treatment of cor pulmonale, however the prognostic implications of need for LD is not known. <bold>Aim:</bold> To investigate whether LD redeemed in the aftermath of COPD exacerbation are associated with 1-year outcomes. <bold>Methods:</bold> Patients with first COPD hospitalization, without previous use of LD or heart failure (HF), alive until 30 days after discharge were identified using Danish nationwide registries. One-year mortality and COPD and HF hospitalization were assessed using survival analysis, by groups of patients with and without incident redeemed LD within 30 days after discharge. We accounted for competing risk of death for the non-fatal outcomes. <bold>Results:</bold> We identified 67,817 patients during 1995-2021 (median age: 71 years (IQR: 63-78), 47% male). As depicted in Figure 1, incident use of LD was associated with increased cumulative incidences of 1-year mortality (A), COPD re-hospitalization (B), and incident HF hospitalization (C). The corresponding adjusted hazard ratios were 1.59 (95% CI: 1.51-1.68), 1.10 (95% CI: 1.05-1.16), and 3.38 (95% CI: 3.05-3.74), using patients without need for LD as reference. <bold>Conclusion:</bold> Incident use of LD in the aftermath of COPD hospitalization, as a marker of cor pulmonale, was associated with increased 1-year mortality and morbidity. <bold>Figure 1.</bold> Cumulative incidences, by groups of patients with and without loop-use. <fig><object-id>erj;64/suppl_68/PA488/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>