Sociodemographic and Geographic Risk Factors for All-Cause Mortality in Patients with COPD

Camille Robichaux,1 Jordan Aron,2 Chris H Wendt,1,3 Jesse D Berman,4 Austin Rau,4 Ann Bangerter,5 R Adams Dudley,1,3,5 Arianne K Baldomero1,3,5 1Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Minnesota, Minneapolis, MN, USA; 2Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN, USA; 3Pulmonary, Allergy, Critical Care, and Sleep Medicine, Minneapolis VA Health Care System, Minneapolis, MN, USA; 4Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN, USA; 5Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USACorrespondence: Camille Robichaux, Division of Pulmonary, Allergy, Critical Care, and Sleep, University of Minnesota, 420 Delaware Street SE, MMC 276, Minneapolis, MN, 55455, USA, Tel +1 612 624-0999, Email robic020@umn.eduBackground: Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality worldwide. Identifying both individual and community risk factors associated with higher mortality is essential to improve outcomes. Few population-based studies of mortality in COPD include both individual characteristics and community risk factors.Objective: We used geocoded, patient-level data to describe the associations between individual demographics, neighborhood socioeconomic status, and all-cause mortality.Methods: We performed a nationally representative retrospective cohort analysis of all patients enrolled in the Veteran Health Administration with at least one ICD-9 or ICD-10 code for COPD in 2016– 2019. We obtained demographic characteristics, comorbidities, and geocoded residential address. Area Deprivation Index and rurality were classified using individual geocoded residential addresses. We used logistic regression models to assess the association between these characteristics and age-adjusted all-cause mortality.Results: Of 1,106,163 COPD patients, 33.4% were deceased as of Ja