Natural Progression of Alpha-1 Antitrypsin Deficiency Among Hospitalized COPD Patients in the US

SESSION TITLE: Genetic and Developmental Disorders Posters SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM PURPOSE: Assessing Chronic Obstructive Pulmonary Disease (COPD) exacerbations among patients with Alpha-1 Antitrypsin Deficiency (AATD) by age strata may help us better understand the natural progression of AATD. We assessed AATD among a sample of COPD inpatients by age to ascertain clinical and economic changes over the course of the disease. METHODS: Using data from the 2009 Nationwide Inpatient Sample (NIS), we identified COPD (ICD-9-CM: 491.xx, 492.xx, or 496.xx) patients with AATD (273.4). We assessed healthcare outcomes (e.g., length of stay, inpatient death, type and number of procedures, and cost of care) by age. Frequencies and percentages for patient demographics were compared using bivariate statistics (e.g., chi-square test). Recognizing the non-parametric nature of length of stay and cost, we calculated median values and interquartile ranges for these variables for each age group of patients. Finally, the multivariable models were fit for each outcome. RESULTS: Of 840,242 hospital admissions with COPD (10.8% of the NIS sample population), 0.08% (684) had a primary or secondary diagnosis code for AATD. Less than 1% were under the age of 20, 5.1% 20-39, 59.8% 40-59, 31.6% 60-79, and 3.2% over age 80. There were substantially more males in the younger age group compared to the older age group (71.4% vs 27.3%). Inpatient death (2.9% 20-39 to 9.1% over 80), mean hospital cost ($13,820 20-39 to $16,079 over 80) and length of stay (5.0 days 20-39 to 8.2 days over 80) all gradually increased with age. Multivariable results were similar when adjusting for severity and hospital characteristics. CONCLUSIONS: AATD prevalence was only 0.08% of COPD admissions; which may be due to under diagnosis. Patient outcomes worsened with age. Age may serve as a good proxy measure to assess disease progression impact. CLINICAL IMPLICATIONS: Understanding disease progressions may help better identify and manage AATD. DISCLOSURE: Christopher Blanchette: Consultant fee, speaker bureau, advisory committee, etc.: Grifols Joshua Noone: Consultant fee, speaker bureau, advisory committee, etc.: Grifols Emily Zacherle: Consultant fee, speaker bureau, advisory committee, etc.: Grifols Michael Runken: Employee: Grifols The following authors have nothing to disclose: Debosree Roy, Bryce Van Doren, Reuben Howden No Product/Research Disclosure Information