Chronic obstructive pulmonary disease and hospitalizations for pneumonia in a US cohort

被引:55
作者
Mannino, David M. [1 ]
Davis, Kourtney J. [2 ]
Kiri, Victor A. [3 ]
机构
[1] Univ Kentucky, Coll Publ Hlth, Dept Prevent Med & Environm Hlth, Lexington, KY 40536 USA
[2] GlaxoSmithKline Res & Dev Ltd, Res Triangle Pk, NC USA
[3] GlaxoSmithKline Res & Dev Ltd, Greenford, Middx, England
关键词
Lung function; COPD; Pneumonia; Hospitalization; Epidemiology; COMMUNITY-ACQUIRED PNEUMONIA; UNITED-STATES; MORTALITY; RISK;
D O I
10.1016/j.rmed.2008.09.005
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To better understand risk factors for pneumonia hospitalizations in people with impaired lung function. Methods: We analyzed longitudinal. data from participants in the Atherosclerosis Risk in Communities Study (ARIC) and the Cardiovascular Health Study (CHS). We limited our analysis to 20,375 participants aged 45 and older at baseline. We stratified the sample based on prebronchodilator baseline lung function data, according to modified GOLD criteria, including a "restrictive" category (FEV1/FVC > 70% and FVC < 80%). We defined "pneumonia" as a hospitalization with a pneumonia discharge diagnosis (ICD-9 codes 480-486) within 36 months. We used Cox proportional hazard models to determine pneumonia risk associated with COPD stage, adjusting for age, sex, race, smoking status and comorbid disease (diabetes mellitus or cardiovascular disease at the baseline examination). Results: Pneumonia hospitalization risk was associated with older age, mate gender, comorbid conditions, smoking status, and level of lung function impairment. Overall, people with normal. lung function had the lowest pneumonia hospitalization rate (1.5 per 1000 person-years) and those with GOLD stage 3 or 4 COPD had the highest rate (22.7 per 1000 person-years). After adjusting for other potential confounding factors, GOLD stages 3 or 4 and 2 COPD were associated with an increased risk of pneumonia (hazard ratio[HR] 5.65, 95% confidence interval [CI] 3.29, 9.67 and 2.25 (1.35, 3.75), respectively) relative to normal tung function. Conclusion: COPD severity (GOLD stage) is an important and independent predictor of pneumonia hospitalizations in this cohort. (C) 2008 Elsevier Ltd. All rights reserved.
引用
收藏
页码:224 / 229
页数:6
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