RT Journal Article
SR Electronic
T1 Incidence and outcomes of hospitalized for COPD exacerbations with and without pneumonia, 2006-2012: A nationwide cohort study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2471
VO 44
IS Suppl 58
A1 Mette Søgaard
A1 Morten Madsen
A1 Anders Løkke
A1 Ole Hilberg
A1 Allan G. Jensen
A1 Jens Dollerup
A1 Reimar W. Thomsen
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2471.abstract
AB Background: Pneumonia may be a major contributor to hospitalizations for COPD exacerbations. We examined the incidence and outcomes of hospitalizations for exacerbations with and without pneumonia in Denmark, 2006-2012.Methods: Using nationwide databases we retrieved complete individual-level data on first-time and successive exacerbations among patients ≥40 years. We estimated exacerbation rates with and without pneumonia per 100,000 persons. We used logistic regression to estimate odds ratios (ORs) of 30-day mortality for with exacerbations with and without pneumonia, adjusted for age, sex, comorbidity, and use of medication as proxy for COPD severity.Results: We identified 156,743 hospitalizations for COPD exacerbation, including 63,591 (41%) first-time exacerbations. Pneumonia was frequent in first exacerbations (46%) but declined in successive exacerbations to 27% in the seventh and following exacerbations. Exacerbations with pneumonia increased by 49%, from 1.23 per 1000 population in 2006 to 1.83 in 2012 while exacerbations without pneumonia increased by 21%, from 1.55 to 1.88. 30-day mortality was 13.1% in patients with first exacerbation with pneumonia and 9.1% in those without pneumonia (aOR 1.25, 95% CI 1.19-1.32). Presence of pneumonia also predicted increased mortality at second exacerbation (aOR 1.22, 95% CI 1.13-1.32), and up to the seventh and following exacerbations (aOR 1.30, 95% CI 1.13-1.50).Conclusions: More than 40% of hospitalized exacerbations in Denmark are associated with pneumonia. Presence of pneumonia predicts increased mortality, both in first and successive exacerbations, and after adjustment for prognostic factors.