(18.06) Increased Mortality in Patients Admitted with Asthma Exacerbation and History of Hypogonadism in the United States

 Using data from the National Inpatient Sample, this retrospective cohort study analyzed 415,230 patients hospitalized for asthma exacerbation between January 2016 and December 2020. It contrasts outcomes between 145 hypogonadism-diagnosed patients (HGD) and 415,085 patients without HGD, focusing on all-cause mortality, length of stay (LOS), and hospital charges. Multiple regression analysis was used to adjust for confounders, assessing demographics with significance determined by the Student’s t-test and chi-square test.

Results:

Mortality rates were significantly higher in asthmatic patients with HGD (3.45%) than in those without HGD (0.19%; P=0.0001). Hypogonadism was associated with increased odds of mortality in patients with asthma (adjusted odds ratio [aOR], 16.22; p=0.007). Factors such as age and higher Charlson Comorbidity Index score also affected mortality. While HGD patients tended towards longer hospital stays, this trend did not reach statistical significance (p=0.077). Hospital charges were notably influenced by racial and household income factors, with significant effects of the Charlson Index on both LOS (coefficient: 0.22; p< 0.001) and hospital charges (coefficient: 2525; p< 0.001). Notably, Hispanic patients had lower mortality risks and shorter LOS than white patients.

Discussion/Conclusion: This study highlights a marked increase in mortality among asthmatic patients with hypogonadism, suggesting a potential role for testosterone in asthma management. It also highlights the influence of demographic and socioeconomic factors on patient outcomes, underscoring the necessity for individualized approaches in treating asthma.