Current Status of Community-Acquired Pneumonia in Patients with Chronic Obstructive Pulmonary Disease

Background: To describe and analyze the incidence and hospital outcomes of patients admitted with community-acquired pneumonia (CAP) according to Chronic Obstructive Pulmonary Disease (COPD) status and sex in Spanish hospitals from 2016 to 2019. Methods: We conducted a cohort study using national hospital discharge data of all patients ≥40 years with CAP. Results: A total of 500,833 patients (59.0% men) was identified. Incidence of CAP increased over time. Age-adjusted incidence was 4.42-times higher in COPD patients. In-hospital mortality (IHM) was lower in men and women with COPD than in those without COPD (14.41% vs. 10.70% in men; 11.12% vs. 8.58%. in women; p < 0.001). The risk of dying in hospital increased with age, presence of several comorbidities (excluding T2DM that was a protective factor), and need for mechanical ventilation (non-invasive and invasive) during admission, irrespective of sex. Over time, the IHM decreased significantly in men and women with COPD. Men with COPD were significantly more likely to die in hospital than were COPD women (OR 1.13; 95%CI 1.07–1.21). Conclusions: Incidence of CAP was higher among subjects with COPD, although the effect of COPD was higher in men than in women. By contrast, IHM was lower in COPD patients, but men with COPD were significantly more likely to die in hospital than were COPD women.

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“…In the future large prospective studies should be done to clarify the role of COPD on the outcome of CAP [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…Community acquired pneumonia (CAP) is an infection of the pulmonary parenchyma that results in a huge economic and health burden [ 1 ]. It is a major cause of hospitalizations, morbidity, and mortality [ 2 ]. Chronic obstructive pulmonary disease (COPD) increases the susceptibility to CAP [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Community-Acquired Pneumonia among Patients with COPD in Spain from 2016 to 2019. Cohort Study Assessing Sex Differences in the Incidence and Outcomes Using Hospital Discharge Data

Miguel‐Díez

López-Herránz

Hernández‐Barrera

et al. 2021

JCM

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“…However, this could also hide other clinical patterns such as therapy. For example, COPD patients on inhaled corticosteroids may have worse outcomes, including death, in the presence of community-acquired pneumonia ( Liu, Han & Liu, 2018 ). To the best of our knowledge there is no evidence on mortality or treatment patterns in COPD patients in Peru.…”

Section: Discussionmentioning

confidence: 99%

A divergence between underlying and final causes of death in selected conditions: an analysis of death registries in Peru

Carrillo‐Larco

Bernabé‐Ortiz

2018

PeerJ

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BackgroundThe underlying cause of death is used to study country and global mortality trends and profiles. The final cause of death could also inform the ultimately cause of death in individuals with underlying conditions. Whether there is a pattern between the underlying and final cause of death has not been explored using national death registries. We studied what final causes of death were most common among selected underlying causes using national death registries in Peru, 2015.MethodsUnderlying and final causes of death were classified according to their ICD-10 codes. Underlying causes included chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), hypertension (HTN), diabetes, and selected cancers (cervix, breast, stomach, prostate, and lung). Final causes were categorized as: communicable, cardiovascular, and cancers. Descriptive statistics were used.ResultsA total of 77,065 death registries were analyzed; cases had a mean age of 69.4 (SD: 19.3) years at death and were mostly men (53.9%). When the underlying cause was HTN, the most frequent final cause was cardiovascular diseases (82.3%). For all the other underlying causes, the most frequent final cause was communicable diseases: COPD (86.4%), CKD (79.3%), cancer (76.5%), and diabetes (68.3%).ConclusionsIn four selected underlying causes of death there was a divergence with respect to the final cause, suggesting there was a shift from non-communicable to communicable causes. Although efforts should be deployed to prevent underlying non-communicable diseases, potential communicable complications should not be neglected.

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“…For example, COPD patients on inhaled corticosteroids may have worse outcomes, including death, in the presence of community-acquired pneumonia. (Liu et al 2018) To the best of our knowledge there is no evidence on mortality or treatment patters in COPD patients in Peru. Although largely speculative, if inhaled corticosteroids were the leading treatment this could explain our results.…”

Section: Comparison With Available Evidence and Interpretation Of Resmentioning

confidence: 98%

Peer Review #1 of "A divergence between underlying and final causes of death in selected conditions: an analysis of death registries in Peru (v0.2)"

Kaufman¹

2018

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Background: The underlying cause of death is used to study country and global mortality trends and profiles. The final cause of death could also inform the ultimately cause of death in individuals with underlying conditions. Whether there is a pattern between the underlying and final cause of death has not been explored using national death registries. We studied what final causes of death were most common among selected underlying causes using national death registries in Peru, 2015. Methods: Underlying and final causes of death were classified according to their ICD-10 codes. Underlying causes included chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), hypertension, diabetes and selected cancers (cervix, breast, stomach, prostate, and lung). Final causes were categorized as: communicable, cardiovascular and cancers. Descriptive statistics were used. Results: 77,065 death registries were analysed; cases had a mean age of 69.4 (SD: 19.3) years and were mostly men (53.9%). When the underlying cause was hypertension, the most frequent final cause was cardiovascular diseases (82.3%). For all the other underlying causes, the most frequent final cause was communicable diseases: COPD (86.4%), CKD (79.3%), cancer (76.5%) and diabetes (68.3%). Conclusions: In four selected underlying causes of death there was a divergence with respect to the final cause, suggesting there was a shift from non-communicable to communicable causes. Although efforts should be deployed to prevent underlying non-communicable diseases, potential communicable complications should not be neglected.

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Current Status of Community-Acquired Pneumonia in Patients with Chronic Obstructive Pulmonary Disease

Cited by 14 publications

References 63 publications

Community-Acquired Pneumonia among Patients with COPD in Spain from 2016 to 2019. Cohort Study Assessing Sex Differences in the Incidence and Outcomes Using Hospital Discharge Data

Community-Acquired Pneumonia among Patients with COPD in Spain from 2016 to 2019. Cohort Study Assessing Sex Differences in the Incidence and Outcomes Using Hospital Discharge Data

A divergence between underlying and final causes of death in selected conditions: an analysis of death registries in Peru

Peer Review #1 of "A divergence between underlying and final causes of death in selected conditions: an analysis of death registries in Peru (v0.2)"

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