Assessing the Impact of Gender and COPD on the Incidence and Mortality of Hospital-Acquired Pneumonia. A Retrospective Cohort Study Using the Spanish National Discharge Database (2016–2019)

Background: We aim to analyze incidence and outcomes of patients hospitalized with hospital-acquired pneumonia (HAP) according to chronic obstructive pulmonary disease (COPD) status and sex in Spain (2016–2019). Methods: We conducted a retrospective cohort study using national hospital discharge dat...

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Autores principales:	Javier de-Miguel-Diez, Rodrigo Jimenez-Garcia, Valentin Hernandez-Barrera, Jose M. de-Miguel-Yanes, David Carabantes-Alarcon, Ana Lopez-de-Andres
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	hospital-acquired pneumonia ventilator-associated pneumonia non-ventilator hospital-acquired pneumonia COPD gender incidence Medicine R
Acceso en línea:	https://doaj.org/article/67d4a0bfddd74615be88129dcb9f1c74
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spelling	oai:doaj.org-article:67d4a0bfddd74615be88129dcb9f1c742021-11-25T18:02:57ZAssessing the Impact of Gender and COPD on the Incidence and Mortality of Hospital-Acquired Pneumonia. A Retrospective Cohort Study Using the Spanish National Discharge Database (2016–2019)10.3390/jcm102254532077-0383https://doaj.org/article/67d4a0bfddd74615be88129dcb9f1c742021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5453https://doaj.org/toc/2077-0383Background: We aim to analyze incidence and outcomes of patients hospitalized with hospital-acquired pneumonia (HAP) according to chronic obstructive pulmonary disease (COPD) status and sex in Spain (2016–2019). Methods: We conducted a retrospective cohort study using national hospital discharge data of patients ≥40 years with a primary diagnosis of HAP, using the specific diagnostics of non-ventilator (NV)-HAP and ventilator-associated pneumonia (VAP). Results: We identified 37,029 patients with HAP ((NV)-HAP 87.28%, VAP 12.72%), 13.40% with COPD. HAP incidence increased over time, but only in subjects without COPD (<i>p</i> < 0.001). In women, incidence of HAP and (NV)-HAP was similar regardless of COPD status, but VAP incidence was lower in COPD women (<i>p</i> = 0.007). In men, the incidence of (NV)-HAP was significantly higher in those with COPD, while VAP incidence was lower in COPD men (<i>p</i> < 0.001). The in-hospital mortality (IHM) was similar in men and women with and without COPD. The risk of dying in hospital increased with age, congestive heart failure, cancer, and dialysis among men and women with COPD. Men that underwent surgery had a lower risk of IHM. VAP increased 2.58-times the probability of dying in men and women. Finally, sex was not associated with IHM among COPD patients. Conclusions: Incidence of HAP was significantly higher in COPD patients than in those without COPD, at the expense of (NV)-HAP but not of VAP. When stratifying by sex, we found that the difference was caused by men. IHM was similar in COPD and non-COPD patients, with no significant change overtime. In addition, sex was not associated with IHM.Javier de-Miguel-DiezRodrigo Jimenez-GarciaValentin Hernandez-BarreraJose M. de-Miguel-YanesDavid Carabantes-AlarconAna Lopez-de-AndresMDPI AGarticlehospital-acquired pneumoniaventilator-associated pneumonianon-ventilator hospital-acquired pneumoniaCOPDgenderincidenceMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5453, p 5453 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	hospital-acquired pneumonia ventilator-associated pneumonia non-ventilator hospital-acquired pneumonia COPD gender incidence Medicine R
spellingShingle	hospital-acquired pneumonia ventilator-associated pneumonia non-ventilator hospital-acquired pneumonia COPD gender incidence Medicine R Javier de-Miguel-Diez Rodrigo Jimenez-Garcia Valentin Hernandez-Barrera Jose M. de-Miguel-Yanes David Carabantes-Alarcon Ana Lopez-de-Andres Assessing the Impact of Gender and COPD on the Incidence and Mortality of Hospital-Acquired Pneumonia. A Retrospective Cohort Study Using the Spanish National Discharge Database (2016–2019)
description	Background: We aim to analyze incidence and outcomes of patients hospitalized with hospital-acquired pneumonia (HAP) according to chronic obstructive pulmonary disease (COPD) status and sex in Spain (2016–2019). Methods: We conducted a retrospective cohort study using national hospital discharge data of patients ≥40 years with a primary diagnosis of HAP, using the specific diagnostics of non-ventilator (NV)-HAP and ventilator-associated pneumonia (VAP). Results: We identified 37,029 patients with HAP ((NV)-HAP 87.28%, VAP 12.72%), 13.40% with COPD. HAP incidence increased over time, but only in subjects without COPD (<i>p</i> < 0.001). In women, incidence of HAP and (NV)-HAP was similar regardless of COPD status, but VAP incidence was lower in COPD women (<i>p</i> = 0.007). In men, the incidence of (NV)-HAP was significantly higher in those with COPD, while VAP incidence was lower in COPD men (<i>p</i> < 0.001). The in-hospital mortality (IHM) was similar in men and women with and without COPD. The risk of dying in hospital increased with age, congestive heart failure, cancer, and dialysis among men and women with COPD. Men that underwent surgery had a lower risk of IHM. VAP increased 2.58-times the probability of dying in men and women. Finally, sex was not associated with IHM among COPD patients. Conclusions: Incidence of HAP was significantly higher in COPD patients than in those without COPD, at the expense of (NV)-HAP but not of VAP. When stratifying by sex, we found that the difference was caused by men. IHM was similar in COPD and non-COPD patients, with no significant change overtime. In addition, sex was not associated with IHM.
format	article
author	Javier de-Miguel-Diez Rodrigo Jimenez-Garcia Valentin Hernandez-Barrera Jose M. de-Miguel-Yanes David Carabantes-Alarcon Ana Lopez-de-Andres
author_facet	Javier de-Miguel-Diez Rodrigo Jimenez-Garcia Valentin Hernandez-Barrera Jose M. de-Miguel-Yanes David Carabantes-Alarcon Ana Lopez-de-Andres
author_sort	Javier de-Miguel-Diez
title	Assessing the Impact of Gender and COPD on the Incidence and Mortality of Hospital-Acquired Pneumonia. A Retrospective Cohort Study Using the Spanish National Discharge Database (2016–2019)
title_short	Assessing the Impact of Gender and COPD on the Incidence and Mortality of Hospital-Acquired Pneumonia. A Retrospective Cohort Study Using the Spanish National Discharge Database (2016–2019)
title_full	Assessing the Impact of Gender and COPD on the Incidence and Mortality of Hospital-Acquired Pneumonia. A Retrospective Cohort Study Using the Spanish National Discharge Database (2016–2019)
title_fullStr	Assessing the Impact of Gender and COPD on the Incidence and Mortality of Hospital-Acquired Pneumonia. A Retrospective Cohort Study Using the Spanish National Discharge Database (2016–2019)
title_full_unstemmed	Assessing the Impact of Gender and COPD on the Incidence and Mortality of Hospital-Acquired Pneumonia. A Retrospective Cohort Study Using the Spanish National Discharge Database (2016–2019)
title_sort	assessing the impact of gender and copd on the incidence and mortality of hospital-acquired pneumonia. a retrospective cohort study using the spanish national discharge database (2016–2019)
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/67d4a0bfddd74615be88129dcb9f1c74
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Assessing the Impact of Gender and COPD on the Incidence and Mortality of Hospital-Acquired Pneumonia. A Retrospective Cohort Study Using the Spanish National Discharge Database (2016–2019)

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