Increased Mortality and Healthcare Utilization in COPD Patients with Cardiovascular Disease

Patients with COPD who also have cardiovascular disease face substantially higher mortality and greater healthcare use, according to a retrospective cohort study.

In this cohort of 7,391 patients with an active COPD episode (January 2015–April 2025), investigators assessed mortality and health‑care utilization — deaths, hospital admissions, emergency department visits, outpatient visits, imaging, and dispensed medication units — using health‑system electronic medical records and multivariable models to adjust for confounders.

Mortality was notably higher with COPD–cardiovascular comorbidity. In fully adjusted models, COPD plus heart failure carried a hazard ratio (HR) of 1.70 versus COPD alone (70% higher mortality); COPD with ischemic heart disease showed HR 1.51, and the subgroup with both HF and IHD had HR 1.40. Overall, 1,873 deaths (25.3%) occurred, with a median time to death of 34 months — providing meaningful absolute‑risk context for risk stratification.

Resource use increased across settings, with more outpatient and urgent‑care visits, higher emergency department utilization, greater imaging, and more dispensed medications. There were also higher hospital admissions (769 patients, 10.4%) and group‑specific admission odds (group 2 OR 1.63; group 4 OR 2.00). Patients who died had longer hospital stays and greater testing intensity per patient, translating into higher bed‑day demand and downstream costs.