Notwithstanding these limitations, our study also has several important strengths, not least the primary care setting used to initially identify patients with COPD, without restrictions in age, employment status, concomitant drug treatments, comorbidities, and healthcare insurance. But what exactly does it mean to have both COPD and pneumonia at the same time? These data confirm that COPD should be considered for inclusion as a comorbid condition for pneumonia severity of illness measures. Patients eligible for matching were receiving fixed combinations of inhaled corticosteroid/long acting β2 agonist (budesonide/formoterol Turbuhaler or fluticasone/salmeterol Diskus). We do not capture any email address. Of the 744 patients identified with an admission diagnosis of CAP, 215 had a concomitant clinical diagnosis of COPD, compared with 529 patients who did not have COPD. Torres et al. LJ was responsible for statistical analyses, CJ for the manuscript draft and finalisation, and GJ for handling of data and the study database. Relevant anonymised patient level data are available on reasonable request from the authors. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. Chronic obstructive pulmonary disease patients hospitalised with community-acquired pneumonia exhibited higher 30- and 90-day mortality than patients without chronic obstructive pulmonary disease. We aimed to determine whether patients with concomitant community‐acquired pneumonia (CAP) and chronic obstructive pulmonary disease (COPD) are at greater risk of death when compared with those with CAP or acute COPD exacerbation alone. This was driven mostly by increases among African American women. People with COPD … The present data show that P. aeruginosa was the second-most-common organism in patients with COPD; therefore, appropriate anti-pseudomonal coverage should be considered in patients with COPD, whether or not bronchiectasis is present. Community-acquired pneumonia (CAP) is one of the most frequent medical causes of hospital admission and still carries a high morbidity and mortality. Funding: This study was funded by AstraZeneca. Data for the crude populations showed a hazard ratio of 1.73 (1.30 to 2.29) for fluticasone/salmeterol compared with budesonide/formoterol. Bacteraemia was present in 53 (10%) hospitalised CAP patients without COPD and 10 (4.6%) patients with COPD. Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States. Chronic obstructive pulmonary disease should be evaluated for inclusion in community-acquired pneumonia … A microbiological diagnosis was assigned in 172 (23%) patients with microorganisms identified from cultures of blood and/or sputum. Long Beach, CA, 2001. Variables were included in the survival analysis if they had either been previously demonstrated to be associated with CAP-related outcomes (e.g. English language editing and assistance with figures was provided by Anna Mett of inScience Communications, Springer Healthcare, and funded by AstraZeneca. The corresponding number needed to treat (NNT) to avoid one pneumonia event per year was 23 (95% confidence interval 18 to 37). We performed sensitivity analyses by analysing rates of pneumonia and mortality from pneumonia in the crude (unmatched) populations and by dividing the matched cohorts into quarters based on the baseline propensity score, denoted as low (first quarter), medium (second quarter), high (third quarter), and very high (fourth quarter) disease burden as a proxy for severity. One of the possible explanations for not finding a higher mortality in these specific groups is that the PSI score does not completely adjust for all of the abnormalities that are common in COPD patients. There were no differences in mortality within 30 or 90 days for CAP patients with COPD who needed ICU admission, received mechanical ventilation or were bacteraemic (table 3⇓). We explored the effect of pneumonia and COPD on inpatient, 30-day and overall mortality. The higher risk of pneumonia in patients treated with fluticasone/salmeterol might be related to differences in immunosuppressant potency and pharmacokinetic and pharmacodynamic properties between budesonide and fluticasone. Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: CJ has received honorariums for educational activities from AstraZeneca, GlaxoSmithKline, and Merck Sharp and Dohme. The standardised difference between the two treatment groups was calculated as the percentage of the absolute difference in population means divided by an estimate of the pooled standard deviation.21. Pneumonia is an important complication of COPD and is reported more often in patients receiving inhaled corticosteroids (ICSs). Chronic obstructive pulmonary disease reduces people’s ability to breathe. 32 Therefore, an increase in pneumonia associated with inhaled corticosteroids would be expected to result in increased mortality. AMI, HF, Pneumonia (PN) Readmission Updates (ZIP) Chronic Obstructive Pulmonary Disease (COPD) Mortality (ZIP) Chronic Obstructive Pulmonary Disease (COPD) Readmission (ZIP) and pneumonia.8 13 20 However, the effect and significance of each predictor on mortality varied across different studies. KL is guarantor. After adjusting for severity of disease and processes of care, CAP patients with COPD showed significantly higher 30- and 90-day mortality than non-COPD patients. The cohort consisted of 582 (78%) males and 162 (22%) females. The authors appreciate the assistance of A. Torres in preparing the manuscript and editorial support. How old were the people who died from COPD in 2012? How many … Compared with budesonide/formoterol, rate of pneumonia and admission to hospital were higher in patients treated with fluticasone/salmeterol: rate ratio 1.73 (95% confidence interval 1.57 to 1.90; P<0.001) and 1.74 (1.56 to 1.94; P<0.001), respectively. Of the patients, 148 (20%) were admitted to the ICU and 83 (14%) required mechanical ventilation. 23 showed, in a large Spanish multicentric study, an in-hospital mortality rate of 8% in a cohort of 124 CAP patients with COPD. Enter multiple addresses on separate lines or separate them with commas. Although COPD prevalence in COVID-19 cases was low in current reports, COVID-19 infection was associated with substantial severity and mortality rates in COPD. Before propensity score matching, the fluticasone/salmeterol population was older, with fewer smokers and patients with diabetes and used lower doses of inhaled corticosteroid; the other variables were similar in the two groups (table 1⇓). Patients diagnosed with chronic obstructive pulmonary disease (COPD) who reported using marijuana had less risk of in-hospital mortality and pneumonia than non-users, according to a … Two Cox’s proportional-hazards models were used to estimate, and plot, baseline survivor functions with either 30- or 90-day mortality as the dependent variable 16. The linked database was held and managed by the Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. Young children, cigarette smokers, adults over 65 and people with certain medical problems including COPD are at greater risk for developing pneumonia. In this observational retrospective matched cohort study patients with chronic obstructive pulmonary disease (COPD) who were treated with fluticasone/salmeterol were significantly more likely to experience pneumonia and had a higher mortality related to pneumonia … Matching for age, sex, and number of exacerbations and pneumonia events in the two years before the index date gave a risk ratio of 1.80 (1.63 to 1.98). Compared to former and never smokers, current smokers were at greater risk of severe complications and higher mortality … The cumulative number of pneumonia events showed a uniform pattern over time (fig 1⇓) and was independent of time after index date. Model discrimination in COPD (C statistic, 0.72) was also similar to that reported for models used for public reporting of hospital mortality in acute myocardial infarction (C statistic, 0.71) and pneumonia … indicates that COPD may not be associated with increased mortality and morbidity in patients hospital-ized with CAP. For both COPD and pneumonia, it is important to see a physician for an accurate diagnosis. Patients treated with either treatment combination were matched on the following criteria during the two years before index and at index: age; sex; available lung function measurements; number of prescriptions for antibiotics, oral steroids, tiotropium, ipratropium, inhaled corticosteroids, short acting β2 agonists, long acting β2 agonists, angiotensin receptor blockers, β blockers, statins, calcium antagonists, and thiazides; diagnosis of diabetes, asthma, cancer, rheumatoid arthritis, heart failure, hypertension, and stroke; and number of previous admissions to hospital. 15 22 This study aims to explore the prognostic indicators for in-hospital mortality in AECOPD patients admitted to a tertiar y care centre in Thailand, a developing country. 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