Highlights
- •Incidence of postoperative pneumonia was higher among COPD than non-COPD patients.
- •In-hospital mortality (IHM) was lower among COPD patients than non-COPD patients.
- •IHM decreased over time, regardless of the existence or not of COPD
- •Higher mortality rates were associated with increasing age and comorbidity
Abstract
Background
To describe and compare incidence, characteristics and outcomes of postoperative pneumonia
among patients with or without COPD.
Methods
We included hospitalized patients aged ≥40 years whose medical diagnosis included
pneumonia and ventilator-associated pneumonia in the secondary's diagnosis field and
who were discharged from Spanish hospitals from 2001 to 2015. Irrespectively of the
position at the procedures coding list, we retrieved data about the type of surgical
procedures using the enhanced ICD-9-CM codes. We grouped admissions by COPD status.
The data were collected from the National Hospital Discharge Database.
Results
We included 117,665 hospitalizations of patients that developed postoperative pneumonia
(18.06% of them had COPD). The incidence of postoperative pneumonia was significantly
higher in COPD patients than in those without COPD (IRR 1.93, 95%CI 1.68–2.24). In
hospital-mortality (IHM) was significantly lower in the first group of patients (29.79%
vs 31.43%, p < 0.05). Factors independently associated with IHM, among COPD and non-COPD patients,
were older age, more comorbidities, mechanical ventilation, pleural drainage tube,
red blood cell transfusion, dialysis and emergency room admission. Time trend analysis
showed a significant decrease in IHM from 2001 to 2015. COPD was associated with lower
IHM (OR 0.91, 95%CI 0.88–0.95).
Conclusions
The incidence of postoperative pneumonia was higher in COPD patients than in those
without this disease. However, IHM was lower among COPD patients. IHM decreased over
time, regardless of the existence or not of COPD.
Keywords
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Article info
Publication history
Published online: February 13, 2018
Accepted:
February 10,
2018
Received in revised form:
January 29,
2018
Received:
November 17,
2017
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
