de Miguel-Diez Javier, Lopez-Herranz Marta, Hernandez-Barrera Valentin, de Miguel-Yanes Jose M, Perez-Farinos Napoleon, Wärnberg Julia, Carabantes-Alarcon David, Jimenez-Garcia Rodrigo, Lopez-de-Andres Ana
Respiratory Department, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Hospital General Gregorio Marañón, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Nursing Department, Faculty of Nursing, Physiotherapy and Podology, Universidad Complutense de Madrid, 28040 Madrid, Spain.
J Clin Med. 2021 Oct 23;10(21):4889. doi: 10.3390/jcm10214889.
To describe and analyze the incidence and hospital outcomes of patients admitted with community-acquired pneumonia (CAP) according to Chronic Obstructive Pulmonary Disease (COPD) status and sex in Spanish hospitals from 2016 to 2019.
We conducted a cohort study using national hospital discharge data of all patients ≥40 years with CAP.
A total of 500,833 patients (59.0% men) was identified. Incidence of CAP increased over time. Age-adjusted incidence was 4.42-times higher in COPD patients. In-hospital mortality (IHM) was lower in men and women with COPD than in those without COPD (14.41% vs. 10.70% in men; 11.12% vs. 8.58%. in women; < 0.001). The risk of dying in hospital increased with age, presence of several comorbidities (excluding T2DM that was a protective factor), and need for mechanical ventilation (non-invasive and invasive) during admission, irrespective of sex. Over time, the IHM decreased significantly in men and women with COPD. Men with COPD were significantly more likely to die in hospital than were COPD women (OR 1.13; 95% CI 1.07-1.21).
Incidence of CAP was higher among subjects with COPD, although the effect of COPD was higher in men than in women. By contrast, IHM was lower in COPD patients, but men with COPD were significantly more likely to die in hospital than were COPD women.
描述并分析2016年至2019年西班牙医院中，根据慢性阻塞性肺疾病（COPD）状态和性别划分的社区获得性肺炎（CAP）患者的发病率及住院结局。
我们利用≥40岁的所有CAP患者的国家医院出院数据进行了一项队列研究。
共识别出500,833例患者（男性占59.0%）。CAP的发病率随时间增加。COPD患者的年龄调整发病率高4.42倍。COPD男性和女性的院内死亡率（IHM）低于无COPD者（男性为14.41%对10.70%；女性为11.12%对8.58%；P<0.001）。住院死亡风险随年龄、多种合并症（不包括作为保护因素的2型糖尿病）的存在以及入院期间对机械通气（无创和有创）的需求而增加，与性别无关。随着时间推移，COPD男性和女性的IHM均显著下降。COPD男性在医院死亡的可能性显著高于COPD女性（比值比1.13；95%置信区间1.07 - 1.21）。
COPD患者中CAP的发病率较高，尽管COPD对男性的影响高于女性。相比之下，COPD患者的IHM较低，但COPD男性在医院死亡的可能性显著高于COPD女性。
