- •Hospital admissions for CAP increased over time in patients with and without COPD.
- •In-hospital mortality decreased over time in both groups of patients.
- •There were no differences in mortality by COPD status during admissions for CAP.
To examine trends in incidence and outcomes of community-acquired pneumonia (CAP) hospitalizations among patients with or without COPD in Spain (2004–2013).
We used national hospital discharge data to select all hospital admissions for CAP. Incidence was calculated overall and according to the presence or absence of COPD.
We identified 901,136 hospital admissions for CAP (32.25% with COPD). Incidence of hospitalizations of CAP increased significantly over time among patients with and without COPD, but it was higher among people with COPD for all years analyzed. S. pneumoniae decreased over time for both groups. Time trend analyses showed significant decreases in mortality during admission for CAP for patients with and without COPD. Factor independently associated with higher mortality in both groups included: male sex, older age, higher comorbidity, isolation of S. aureus or P. aeruginosa, use of mechanical ventilation, and readmission. The presence of COPD was associated with a lower in-hospital mortality (IHM) (OR: 0.58, 95%CI 0.57–0.59).
The incidence of hospitalizations for CAP increased over time in patients with and without COPD, being higher in the COPD population for all years analyzed. IHM decreased over time in both groups. There were no differences in mortality between COPD and non-COPD patients.
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- Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults.Clin Infect Dis. 2007; 44S27-72
- Community-acquired pneumonia requiring hospitalization: 5-year prospective study.Rev Infect Dis. 1989; 11: 586-599
- Treatment failure in community-acquired pneumonia.Chest. 2007; 132: 1348-1355
- A prediction rule to identify low-risk patients with community-acquired pneumonia.N Engl J Med. 1997; 336: 243-250
- Prognosis in patients with pneumonia and chronic obstructive pulmonary disease.Arch Bronconeumol. 2005; 41: 607-611
- Epidemiology of community-acquired pneumonia in adult patients at the dawn of the 21st century: a prospective study on the Mediterranean coast of Spain.Clin Microbiol Infect. 2005; 11: 788-800
- Characteristics of community-acquired pneumonia in patients with chronic obstructive pulmonary disease.Respir Med. 2007; 101: 2139-2144
- Implications of COPD in patients admitted to the intensive care unit by community-acquired pneumonia.Eur Respir J. 2006; 27: 1210-1216
- COPD is associated with increased mortality in patients with community-acquired pneumonia.Eur Respir J. 2006; 28: 346-351
- Community-acquired pneumonia in patients with and without chronic obstructive pulmonary disease.J Inf Secur. 2009; 58: 417-424
- The influence of COPD on mortality and severity scoring in community-acquired pneumonia.Respiration. 2010; 79: 46-53
- Severity and outcomes of hospitalised community-acquired pneumonia in COPD patients.Eur Respir J. 2012; 39: 855-861
- Risk factors for community-acquired pneumonia diagnosed by general practitioners in the community.Respir Med. 2000; 94: 422-427
- Clinical features, etiology and outcomes of community-acquired pneumonia in patients with chronic obstructive pulmonary disease.PLoS One. 2014; 9e105854
- Etiology and factors contributing to the severity and mortality of community-acquired pneumonia.Intern Med. 2013; 52: 317-324
- Risk factors for complicated parapneumonic effusion and empyema on presentation to hospital with community-acquired pneumonia.Thorax. 2009; 64: 592
- Pulmonary complications of pneumococcal community-acquired pneumonia: incidence, predictors, and outcomes.Clin Microbiol Infect. 2012; 18: 1134-1142
- Is COPD associated with increased mortality and morbidity in hospitalized pneumonia? A systematic review and meta-analysis.Respirology. 2015; 20: 1046-1054
- Increasing hospital admissions for pneumonia, England.Emerg Infect Dis. 2008; 14: 727-733
- Is secondary preventive care improving? Observational study of 10-year trends in emergency admissions for conditions amenable to ambulatory care.BMJ Open. 2013; 3
- Seasonality, risk factors and burden of community-acquired pneumonia in COPD patients: a population database study using linked health care records.Int J Chron Obstruct Pulmon Dis. 2017; 12: 313-322
- Conjunto Mínimo Básico de Datos, Hospitales del INSALUD.(Available from:)(Accessed October 6, 2015)
- A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.J Chronic Dis. 1987; 40: 373-383
- Type 2 diabetes and pneumonia outcomes. A population-based cohort study.Diabetes Care. 2007; 30: 2251-2257
- Servicios Sociales e Igualdad: [Encuesta Nacional de Salud de España].(Available from)(Accessed December 1, 2015)
- Population estimates 2010.(Available from)(Accessed December 1, 2015)
- Nationwide trends in pneumonia hospitalization rates and mortality, Denmark 1997–2011.Respir Med. 2014; 108: 1214-1222
- Increasing burden of community-acquired pneumonia leading to hospitalisation, 1998–2014.Thorax. 2016; 71: 535-542
- Trends in hospitalizations for pneumonia among persons aged 65 years or older in the United States, 1988–2002.JAMA. 2005; 294: 2712-2719
- Community-acquired pneumonia requiring hospitalization among U.S. adults.N Engl J Med. 2015; 373: 415-427
- New evidence of risk factors for community-acquired pneumonia: a population-based study.Eur Respir J. 2008; 31: 1274-1284
- Obesity survival paradox in pneumonia: a meta-analysis.BMC Med. 2014; 12: 61
- Incident pneumonia and mortality in patients with chronic obstructive pulmonary disease. A double effect of inhaled corticosteroids?.Am J Respir Crit Care Med. 2015; 191: 141-148
- Influence of previous use of inhaled corticoids on the development of pleural effusion in community-acquired pneumonia.Am J Respir Crit Care Med. 2013; 187: 1241-1248
- Role of first-line noninvasive ventilation in non-COPD subjects with pneumonia.Arch Bronconeumol. 2016 Dec 14; (pii: S0300-2896(16)30256-3)
- Trends in pathogens among patients hospitalized for pneumonia from 1993 to 2011.JAMA Intern Med. 2014; 174: 1837-1839
- Trends in infectious disease mortality rates, Spain, 1980–2011.Emerg Infect Dis. 2014; 20: 782-789
- Declining mortality among hospitalized patients with community-acquired pneumonia.Clin Microbiol Infect. 2016; 22567.e1-7
- Prognostic factors in hospitalized community-acquired pneumonia: a retrospective study of a prospective observational cohort.BMC Pulm Med. 2017; 17: 78
- Staphylococcus aureus community-acquired pneumonia: prevalence, clinical characteristics, and outcomes.Clin Infect Dis. 2016; 63: 300-309
- Early mortality in patients with community-acquired pneumonia: causes and risk factors.Eur Respir J. 2008; 32: 733-739
- The outcome of community-acquired pneumonia in patients with chronic lung disease: a case-control study.Swiss Med Wkly. 2014; 144: w14013
- New perspectives on community-acquired pneumonia in 388 406 patients. Results from a nationwide mandatory performance measurement programme in healthcare quality.Thorax. 2009; 64: 1062-1069
- Observational study of inhaled corticosteroids on outcomes for COPD patients with pneumonia.Am J Respir Crit Care Med. 2011; 184: 312-316
- Inhaled corticosteroid use is associated with lower mortality for subjects with COPD and hospitalised with pneumonia.Eur Respir J. 2010; 36: 751-757
- Chronic obstructive pulmonary disease and mortality from pneumonia: meta-analysis.Int J Clin Pract. 2013; 67: 477-487
- Use of noninvasive ventilation in patients with acute respiratory failure, 2000–2009: a population-based study.Ann Am Thorac Soc. 2013; 10: 10-17
- The role of noninvasive positive pressure ventilation in community-acquired pneumonia.Crit Care. 2015; 30: 49-54
- Association between noninvasive ventilation and mortality among older patients with pneumonia.Crit Care Med. 2017; 45e246-54
- Trends in hospital admissions for acute exacerbation of COPD in Spain from 2006 to 2010.Respir Med. 2013; 107: 717-723
- Validity of procedure codes in International Classification of Diseases, 9th revision, clinical modification administrative data.Med Care. 2004; 42: 801-809
- Predicting in-hospital mortality with coronary bypass surgery using hospital discharge data: comparison with a prospective observational study.Rev Esp Cardiol. 2008; 61: 843-852
Published online: June 11, 2017
Accepted: June 8, 2017
Received in revised form: June 7, 2017
Received: April 8, 2017
© 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.