Factors Associated With Frequent Exacerbation-Related Hospitalization in Chronic Obstructive Pulmonary Disease (COPD): A Hospital-Based Analytical Cross-Sectional Study From Central India.

BACKGROUND

Recurrent exacerbations of chronic obstructive pulmonary disease (COPD) are an important cause of hospitalization. The contribution of modifiable behavioral, environmental, and treatment-related factors may vary across clinical settings. This study evaluated factors associated with frequent exacerbation-related hospitalization among patients admitted with acute exacerbation of COPD in Central India.

METHODS

This hospital-based analytical cross-sectional study enrolled 100 consenting adults with COPD who were admitted with an acute exacerbation between August 2, 2023, and August 3, 2024. Exposures were recorded at the index admission, and exacerbation-related hospitalizations during the preceding year were ascertained retrospectively using a study-specific prestructured proforma. The primary outcome was frequent exacerbation-related hospitalization, defined as two or more such hospitalizations during the preceding year. Categorical variables were compared using Pearson's chi-square test or Fisher's exact test, as appropriate, and unadjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.

RESULTS

Sixty patients (60.0%) had two or more exacerbation-related hospitalizations during the preceding year. In unadjusted analyses, frequent exacerbation-related hospitalization was associated with older age (p = 0.024), smoking (OR 18.94, 95% CI 5.75-62.42), alcohol use (OR 2.67, 95% CI 1.15-6.21), indoor air pollution (OR 2.80, 95% CI 1.21-6.46), secondhand smoke exposure (OR 2.71, 95% CI 1.16-6.37), environmental dust exposure (OR 4.64, 95% CI 1.80-11.91), and medication discontinuation (OR 3.27, 95% CI 1.35-7.95).

CONCLUSIONS

Frequent exacerbation-related hospitalization was common and showed unadjusted associations with several potentially modifiable exposures and interruption of maintenance treatment. These exploratory findings support assessment of smoking, environmental exposures, and treatment continuity during admission but do not establish independent or causal effects.