Systematic Cluster Analysis of Comorbidity Patterns in Patients with Chronic Obstructive Pulmonary Disease and the Impact on Hospitalization Costs
摘要
Background Chronic obstructive pulmonary disease (COPD) patients often present with multiple comorbidities, which increase the complexity of treatment and the healthcare of burden. While comorbidities significantly impact the management of COPD patients, existing research primarily focuses on individual comorbidities, lacking systematic analysis of multiple comorbidity patterns and hospitalization costs. Objective To investigate the comorbidity characteristics and patterns in patients with COPD, analyzing how different features and comorbidity patterns affect hospitalization costs. The findings will provide a basis for personalized health management and resource allocation for COPD patients. Methods A retrospective analysis was conducted on 5 061 inpatients diagnosed with COPD at the First Affiliated Hospital, Guangzhou Medical University from 2020 to 2023. Systematic clustering analysis was employed to construct dendrograms, identifying comorbidity patterns among COPD patients. Multiple group comparisons were performed to assess the basic characteristics of these patterns, then multiple linear regression analysis was utilized to evaluate the impact of each comorbidity pattern on total hospitalization costs, western medicine costs, and antibacterial medication costs. Results There are a total of 4 343 patients with COPD, and the comorbidity was 85.81%. Systematic clustering analysis identified six comorbidity patterns among COPD patients: cardiovascular and metabolic diseases, hepatorenal diseases, digestive system diseases, arthropathy diseases, cancer and respiratory system diseases. There were significant differences in sex, age, BMI and smoking history among patients with 6 comorbidity models (P<0.05). Multiple linear regression analysis revealed that BMI, cancer pattern, and respiratory system diseases pattern all had impacts on total hospitalization costs, western medicine costs and antibacterial medication costs (P<0.05), with the respiratory system dis