Presentation (CTI)

OBJECTIVES: To evaluate the impact of socioeconomic status (SES) differences on symptom burden, measured by the COPD Assessment Test (CAT), among hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and to identify associated influencing factors for stratified clinical management.
METHODS: A total of 188 AECOPD inpatients were enrolled. Socioeconomic, demographic, behavioral, pulmonary, and psychological data were collected. Latent class analysis (LCA) using education level, occupation, monthly income, and insurance type identified SES subgroups. Baseline CAT scores (CAT_origin) were analyzed via stepwise multiple linear regression models adjusting sequentially for demographic, behavioral, pulmonary, and psychological factors.
RESULTS: Two latent SES subgroups were identified:High SES (46.5%) — predominantly retired males (89%), higher education (23% with bachelor’s degree or above), urban employee insurance (97%), and higher income (≥5,000 RMB, 70%).Low SES (53.5%) — mainly farmers (88%) with lower education (71% primary or below), urban-rural resident insurance (93%), and income below 2,000 RMB (63%) (p < 0.05). In regression analyses, SES showed a marginal association with CAT scores in the unadjusted model (p = 0.062) but became nonsignificant after adjustment. Significant predictors of higher CAT scores included age (β = 0.13, p = 0.029), lower BMI (β = −0.48, p = 0.001), shorter sleep duration (β = −0.80, p = 0.006), reduced FEV₁% (β = −0.08, p = 0.037), higher anxiety (β = −0.38, p = 0.014), and depression scores (β = −0.59, p < 0.001).
CONCLUSIONS: Symptom burden in hospitalized COPD patients is influenced by multiple factors, including age, BMI, sleep duration, lung function, and psychological status. SES influences symptoms indirectly through psychological and behavioral pathways. Integrating physiological and psychosocial interventions is essential to optimize symptom management and improve quality of life among AECOPD patients.