Sex-differences in mortality after first hospitalization for COPD exacerbation – a nationwide cohort study

<bold>Background:</bold> Sex-specific data on outcomes among patients with COPD after acute exacerbations (AECOPD) remain sparse. <bold>Aim:</bold> To investigate sex differences in 30-day and 1-year mortality after first hospitalization with AECOPD. <bold>Methods:</bold> We included all patients aged >40 with first hospitalization with COPD during 2000-2022 using Danish national registries. Mortality within 30 days and 1 year from the date of admission was estimated using the 1-Kaplan-Meier method. Cox proportional hazards models were used to compare mortality between sexes adjusting for age, comorbidities, and level of COPD severity. <bold>Results:</bold> Figure 1 shows the mortality by sex. We included 141,106 patients (52% female). Median age was 74 years (IQR: 67-81) for males and 75 years (IQR: 67-82) for females. Thirty-day and 1-year mortality were 11.4% (95%CI: 11.2-11.7) and 31.4% (95%CI: 31.0-31.7) for males and 10.0% (95% CI: 9.79-10.2) and 26.3% (95% CI: 26.0-26.7) for females. Male sex was associated with higher 30-day (adjusted HR 1.12; 1.08-1.15) and 1-year mortality (adjusted HR 1.19; 1.16-1.21) compared with females. <bold>Conclusion:</bold> Male sex was associated with a higher 30 days- and 1-year mortality after AECOPD compared with females. Sex-specific risk assessment and management strategies may be needed. <bold>Figure 1:</bold> Kaplan-Meier curve showing cumulative mortality by sex 30 days (A) and 1 year (B) after first hospitalization for COPD exacerbation. <fig><object-id>erj;66/suppl_69/PA3676/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>