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Risks of Pneumonia in COPD Patients with New-Onset Atrial Fibrillation

The association between Atrial Fibrillation (AF) and pneumonia remains unclear. This study aims to assess the impact of AF on high pneumonia risk group—chronic obstructive pulmonary disease (COPD)—In order to find the association between AF and the risk of pneumonia. The COPD cohort was extracted fr...

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Autores principales: Wang, Ya-Hui, Lai, Chih-Cheng, Wang, Cheng-Yi, Wang, Hao-Chien, Yu, Chong-Jen, Chen, Likwang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6162855/
https://www.ncbi.nlm.nih.gov/pubmed/30134632
http://dx.doi.org/10.3390/jcm7090229
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author Wang, Ya-Hui
Lai, Chih-Cheng
Wang, Cheng-Yi
Wang, Hao-Chien
Yu, Chong-Jen
Chen, Likwang
author_facet Wang, Ya-Hui
Lai, Chih-Cheng
Wang, Cheng-Yi
Wang, Hao-Chien
Yu, Chong-Jen
Chen, Likwang
author_sort Wang, Ya-Hui
collection PubMed
description The association between Atrial Fibrillation (AF) and pneumonia remains unclear. This study aims to assess the impact of AF on high pneumonia risk group—chronic obstructive pulmonary disease (COPD)—In order to find the association between AF and the risk of pneumonia. The COPD cohort was extracted from National Health Research Institute of Taiwan. The AF cohort comprised all COPD patients with new-onset AF (International Classification of Diseases (ICD)-9 code 427.31) after COPD diagnosis. We further sampled non-AF cohort and performed 1:1 propensity score matched analysis to improve the balance of baseline characteristics between AF and non-AF cohort. The outcomes were pneumonia and pneumonia requiring mechanical ventilation (MV). From 2000–2011, a total of 6228 patients with COPD and AF, and matched 84,106 control subjects were enrolled. After propensity score matching, we identified 6219 patients, each with AF, and matched controls without AF. After propensity score matching, the AF cohorts had higher risk of mortality (adjusted hazard ratio (aHR), 1.24; 95% confidence interval (CI), 1.15–1.34), pneumonia (aHR, 1.17; 95% CI, 1.07–1.27), and pneumonia requiring MV (aHR, 1.33; 95% CI, 1.18–1.50) in comparison with the matched non-AF cohort. After adjusting for mortality from causes other than outcomes of interest as a competing risk, AF remains significantly associated with pneumonia and pneumonia requiring MV. The risks of pneumonia were higher in this population with AF than in those without AF, and the risk was still significant after the adjustment for the competing risk of all-cause mortality.
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spelling pubmed-61628552018-10-02 Risks of Pneumonia in COPD Patients with New-Onset Atrial Fibrillation Wang, Ya-Hui Lai, Chih-Cheng Wang, Cheng-Yi Wang, Hao-Chien Yu, Chong-Jen Chen, Likwang J Clin Med Article The association between Atrial Fibrillation (AF) and pneumonia remains unclear. This study aims to assess the impact of AF on high pneumonia risk group—chronic obstructive pulmonary disease (COPD)—In order to find the association between AF and the risk of pneumonia. The COPD cohort was extracted from National Health Research Institute of Taiwan. The AF cohort comprised all COPD patients with new-onset AF (International Classification of Diseases (ICD)-9 code 427.31) after COPD diagnosis. We further sampled non-AF cohort and performed 1:1 propensity score matched analysis to improve the balance of baseline characteristics between AF and non-AF cohort. The outcomes were pneumonia and pneumonia requiring mechanical ventilation (MV). From 2000–2011, a total of 6228 patients with COPD and AF, and matched 84,106 control subjects were enrolled. After propensity score matching, we identified 6219 patients, each with AF, and matched controls without AF. After propensity score matching, the AF cohorts had higher risk of mortality (adjusted hazard ratio (aHR), 1.24; 95% confidence interval (CI), 1.15–1.34), pneumonia (aHR, 1.17; 95% CI, 1.07–1.27), and pneumonia requiring MV (aHR, 1.33; 95% CI, 1.18–1.50) in comparison with the matched non-AF cohort. After adjusting for mortality from causes other than outcomes of interest as a competing risk, AF remains significantly associated with pneumonia and pneumonia requiring MV. The risks of pneumonia were higher in this population with AF than in those without AF, and the risk was still significant after the adjustment for the competing risk of all-cause mortality. MDPI 2018-08-21 /pmc/articles/PMC6162855/ /pubmed/30134632 http://dx.doi.org/10.3390/jcm7090229 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wang, Ya-Hui
Lai, Chih-Cheng
Wang, Cheng-Yi
Wang, Hao-Chien
Yu, Chong-Jen
Chen, Likwang
Risks of Pneumonia in COPD Patients with New-Onset Atrial Fibrillation
title Risks of Pneumonia in COPD Patients with New-Onset Atrial Fibrillation
title_full Risks of Pneumonia in COPD Patients with New-Onset Atrial Fibrillation
title_fullStr Risks of Pneumonia in COPD Patients with New-Onset Atrial Fibrillation
title_full_unstemmed Risks of Pneumonia in COPD Patients with New-Onset Atrial Fibrillation
title_short Risks of Pneumonia in COPD Patients with New-Onset Atrial Fibrillation
title_sort risks of pneumonia in copd patients with new-onset atrial fibrillation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6162855/
https://www.ncbi.nlm.nih.gov/pubmed/30134632
http://dx.doi.org/10.3390/jcm7090229
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