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Research Snapshot Theater: Pulmonary/Epidemiology - Outcomes, Adult

The Winter Burden of COPD: Analysis of Seasonal Exacerbations and Respiratory Support Needs

Monday, March 23, 2026
11:30 AM - 12:30 PM Central Time
Location: Connections Central - RST 18

  • Dhiraj Regmi, MBBS

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • SR

    Sabita Regmi, N/A

    Medical Student, MS3
    Tribhuvan University Teaching Hospital

    Disclosure information not submitted.

Introduction: The seasonal increase in incidence of COPD exacerbation during the winter months of November to February is well known. The cause of the variation is thought to be respiratory viruses that circulate in the colder months. However, it is unknown if mortality follows the same trends. The goal of our study is to compare the incidence, length of hospital stay, mortality and intubation rates of COPD exacerbation during the winter months versus other months of the year.


Methods: A retrospective analysis of the Healthcare Cost and Utilization Project (HCUP) 2022 Nationwide Inpatient Sample (NIS) was performed. Patients with COPD exacerbation were identified by the ICD-10 codes: J44.1, J41.0, J41.1, J41.8, J45, J43.0, J43.1, J43.8, J43.9, J44.0, J44.9 as the primary diagnosis. The following codes were used to identify intubation: 0BH17EZ and 0BH18EZ. Sample weighting was employed to produce national estimates. Multivariable survey‑weighted logistic and linear regression models adjusted for age, sex, race, primary payer, Charlson Comorbidity Index, hospital teaching status, location, and bed size were used to compare outcomes.


Results: A total of 297,030 nationally weighted admissions for COPD exacerbation were identified in the 2022 NIS. Admissions were highest in November and December (≈30,000 each) and lowest in February and July (≈19,000–21,000). After adjustment, winter admission remained independently associated with a 0.17-day longer stay (β=0.17, 95% CI 0.07–0.26, p=0.001). In-hospital mortality was higher in winter compared to other months (1.65% vs. 1.24%). Multivariable logistic regression confirmed that winter admission independently increased mortality by 34% (OR 1.34, 95% CI 1.14–1.57, p< 0.001). Adjusted analysis showed 15% higher odds of intubation during winter admissions (OR 1.15, 95% CI 1.02–1.29, p=0.022).


Conclusions: Even though admissions in winter were lower in 2022 compared to spring and fall, winter admissions due to exacerbation of COPD were associated with longer length of stay, mortality and higher odds of intubation.