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• W4387253181 abstract "SESSION TITLE: Genetic and Developmental Disorders Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Alpha-1 antitrypsin deficiency (AD) is a rare genetic condition contributing to the development of chronic obstructive pulmonary disease. Our aim was to characterize the patient demographics and cardio-pulmonary outcomes in patients with alpha-1 antitrypsin deficiency in the setting of acute exacerbation of chronic obstructive pulmonary disease (CE). METHODS: This was a retrospective cohort study using the 2019 Nationwide Inpatient Sample database to identify admissions in adults with diagnoses of AD and CE. Multivariate linear and logistic regression models were adjusted for demographic variables. Primary outcomes were cardiovascular outcomes and all-cause mortality, and secondary outcomes were length of stay (LOS) and total charge in USD. RESULTS: Out of 1,438,808 CE, 2849 had AD. Compared to non-AD-CE cohort, AD-CE cohort had more females (59.86% vs 55.20%,p<0.05), lower mean age (60.89 vs 69.13,p<0.001), more White patients (92.25% vs 76.57%,p<0.001), fewer Black patients (3.52% vs 12.98,p<0.001), and fewer Hispanic (1.06% vs 5.02%,p<0.001). Both cohorts had similar distribution of Asian & Pacific Islander (0.0% vs 1.25%,p=0.1015) and Native American (0.35% vs 0.55%,p=0.5269). The presence of AD was associated with a lower odds of atrial fibrillation OR 0.53 (95%CI 0.42-0.68,p<0.001), Type 2 diabetes mellitus OR 0.56 (95%CI 0.45-0.69,p<0.001), non-ST elevation myocardial infarction OR 0.32 (95%CI 0.14-0.77,p<0.05), heart failure with reduced ejection fraction OR 0.44 (95%CI 0.27-0.70,p<0.01), heart failure with preserved ejection fraction OR 0.44 (95%CI 0.34-0.57,p<0.001), malignant lung cancer OR 0.37 (95%CI 0.20-0.73), and acute respiratory failure OR 0.51 (95%CI 0.41-0.65, p<0.001). The presence of AD had a higher odds of migraine OR 2.19 (95%CI 1.32-3.63,p<0.01), bronchiectasis OR 4.47 (95%CI 2.30- 8.53, p<0.001), lung transplant OR 21.14 (95%CI 5.10-87.68,p<0.001), chronic respiratory failure OR 2.34 (95%CI 1.88-2.92,p<0.001), and supplemental O2 requirement OR 2.30 (95%CI 1.95-2.72,p<0.001). There were no differences between the cohorts with respect to pulmonary embolism OR 0.65 (95%CI 0.27-1.57,p=0.338), ventilator dependence OR 1.15 (95%CI 0.37-3.58,p=0.806), acute liver failure OR 0.72 (95%CI 0.18-2.90,p=0.639), type 1 diabetes mellitus, cardiac arrest OR 0.58 (95%CI 0.19-1.79,p=0.340), cardiogenic shock OR 0.55 (95%CI 0.14-2.19,p=392), and pneumothorax OR 1.22 (95%CI 0.46-3.30,p=0.689). CE-AD cohort had similar all-cause mortality rate (2.29 % vs 3.04%,p=0.2957), all-cause mortality OR 1.10 (95%CI 0.60-1.89,p=0.844), mean LOS (5.14 vs 5.52 days,p=0.316), and mean total hospitalization charge ($60149.58 vs $49482.25,p=0.457). CONCLUSIONS: In patients with CE, the presence of AD was associated with increased odds of bronchiectasis, chronic respiratory failure, supplemental O2 requirement and lung transplant, and decreased odds of atrial fibrillation, heart failure, acute respiratory failure. AD was more prevalent in females, younger patients and White patients. There was no significant difference in all-cause mortality, LOS, hospitalization charge as well as development of pulmonary embolism, pneumothorax, or cardiogenic shock. CLINICAL IMPLICATIONS: Alpha-1 antitrypsin deficiency is a topic that is rarely studied, the results of our study will help characterize patient demographics and better guide health care workers on which patients should be screened It will aid clinicians in improving the care for Alpha-1 antitrypsin deficiency patients as it highlights the cardiac and pulmonary comorbidities and clinical outcomes 3. It demonstrates that no additional hospital resources are expended with the care of Alpha-1 antitrypsin deficiency patients DISCLOSURES: No relevant relationships by Ibrahim Ahmed No relevant relationships by Richard Amoateng No relevant relationships by Kavya Shankar" @default.
• W4387253181 created "2023-10-03" @default.
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• W4387253181 date "2023-10-01" @default.
• W4387253181 modified "2023-10-03" @default.
• W4387253181 title "THE PRESENCE OF ALPHA-1 ANTITRYPSIN DEFICIENCY IN ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE: ANALYSIS OF PATIENT DEMOGRAPHICS AND CARDIO-PULMONARY OUTCOMES" @default.
• W4387253181 doi "https://doi.org/10.1016/j.chest.2023.07.2561" @default.
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