Mortality in Patients Admitted for Concurrent COPD Exacerbation and Pneumonia.

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  • Additional Information
    • Author-Supplied Keywords:
      COPD epidemiology
      COPD exacerbation
      health-care utilization
      respiratory infection
    • Abstract:
      It is unclear whether concurrent pneumonia and chronic obstructive pulmonary disease (COPD) have a higher mortality than either condition alone. Further, it is unknown how this interaction changes over time. We explored the effect of pneumonia and COPD on inpatient, 30-day and overall mortality. We used a Veterans Health Affairs database to compare patients who were hospitalized for a COPD exacerbation without pneumonia (AECOPD), patients hospitalized for pneumonia without COPD (PNA) and patients hospitalized for pneumonia who had a concurrent diagnosis of COPD (PCOPD). We studied records of 15,065 patients with the following primary discharge diagnoses: (a) AECOPD cohort (7,154 individuals); (b) PNA cohort (4,433 individuals); and (c) PCOPD (3,478 individuals), comparing inpatient, 30-day and overall mortality in the three study cohorts. We observed a stepwise increase in inpatient mortality for AECOPD, PNA and PCOPD (4.8%, 9.5% and 13.2%, respectively). These differences persisted at 30 days post-discharge (AECOPD = 6.7%, PNA = 12.4% and PCOPD = 14.6%;p< 0.0001), but not throughout the study period (median follow-up: 37 months). With time, the death rate rose disproportionally in patients who had been admitted for AECOPD (AECOPD = 64.5%; PNA = 57.4% and PCOPD 66.2%;p< 0.001). In multivariate analysis, PCOPD predicted the greatest inpatient mortality (p< 0.001). The data showed a progression in inpatient and 30-day mortality from AECOPD to PNA to PCOPD. Pneumonia and COPD differentially affected inpatient, 30-day and overall mortality with pneumonia affecting predominantly inpatient and 30-day mortality while COPD affecting the overall mortality. [ABSTRACT FROM AUTHOR]
    • Abstract:
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    • Author Affiliations:
      1Medical Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
      2Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX, USA
      3DoD/VA Vision Center of Excellence, Bethesda, MD, USA
      4Allied Health Sciences, Baylor College of Medicine, Houston, TX, USA
      5Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA
    • ISSN:
      1541-2555
    • Accession Number:
      10.1080/15412555.2016.1220513
    • Accession Number:
      120860402
  • Citations
    • ABNT:
      SHARAFKHANEH, A. et al. Mortality in Patients Admitted for Concurrent COPD Exacerbation and Pneumonia. COPD: Journal of Chronic Obstructive Pulmonary Disease, [s. l.], v. 14, n. 1, p. 23–29, 2017. DOI 10.1080/15412555.2016.1220513. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=a9h&AN=120860402&custid=s6224580. Acesso em: 22 jan. 2020.
    • AMA:
      Sharafkhaneh A, Spiegelman AM, Main K, Tavakoli-Tabasi S, Lan C, Musher D. Mortality in Patients Admitted for Concurrent COPD Exacerbation and Pneumonia. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2017;14(1):23-29. doi:10.1080/15412555.2016.1220513.
    • APA:
      Sharafkhaneh, A., Spiegelman, A. M., Main, K., Tavakoli-Tabasi, S., Lan, C., & Musher, D. (2017). Mortality in Patients Admitted for Concurrent COPD Exacerbation and Pneumonia. COPD: Journal of Chronic Obstructive Pulmonary Disease, 14(1), 23–29. https://doi.org/10.1080/15412555.2016.1220513
    • Chicago/Turabian: Author-Date:
      Sharafkhaneh, Amir, Andrew M. Spiegelman, Kevin Main, Shahriar Tavakoli-Tabasi, Charlie Lan, and Daniel Musher. 2017. “Mortality in Patients Admitted for Concurrent COPD Exacerbation and Pneumonia.” COPD: Journal of Chronic Obstructive Pulmonary Disease 14 (1): 23–29. doi:10.1080/15412555.2016.1220513.
    • Harvard:
      Sharafkhaneh, A. et al. (2017) ‘Mortality in Patients Admitted for Concurrent COPD Exacerbation and Pneumonia’, COPD: Journal of Chronic Obstructive Pulmonary Disease, 14(1), pp. 23–29. doi: 10.1080/15412555.2016.1220513.
    • Harvard: Australian:
      Sharafkhaneh, A, Spiegelman, AM, Main, K, Tavakoli-Tabasi, S, Lan, C & Musher, D 2017, ‘Mortality in Patients Admitted for Concurrent COPD Exacerbation and Pneumonia’, COPD: Journal of Chronic Obstructive Pulmonary Disease, vol. 14, no. 1, pp. 23–29, viewed 22 January 2020, .
    • MLA:
      Sharafkhaneh, Amir, et al. “Mortality in Patients Admitted for Concurrent COPD Exacerbation and Pneumonia.” COPD: Journal of Chronic Obstructive Pulmonary Disease, vol. 14, no. 1, Feb. 2017, pp. 23–29. EBSCOhost, doi:10.1080/15412555.2016.1220513.
    • Chicago/Turabian: Humanities:
      Sharafkhaneh, Amir, Andrew M. Spiegelman, Kevin Main, Shahriar Tavakoli-Tabasi, Charlie Lan, and Daniel Musher. “Mortality in Patients Admitted for Concurrent COPD Exacerbation and Pneumonia.” COPD: Journal of Chronic Obstructive Pulmonary Disease 14, no. 1 (February 2017): 23–29. doi:10.1080/15412555.2016.1220513.
    • Vancouver/ICMJE:
      Sharafkhaneh A, Spiegelman AM, Main K, Tavakoli-Tabasi S, Lan C, Musher D. Mortality in Patients Admitted for Concurrent COPD Exacerbation and Pneumonia. COPD: Journal of Chronic Obstructive Pulmonary Disease [Internet]. 2017 Feb [cited 2020 Jan 22];14(1):23–9. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=a9h&AN=120860402&custid=s6224580