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The Impact of Sepsis on the Outcomes of COPD Patients: A Population-Based Cohort Study

This study aims to identify the impact of new-onset sepsis in patients with chronic obstructive pulmonary disease (COPD) including the effects on acute exacerbations, pneumonia and mortality. Using the National Health Insurance Research Database of Taiwan, all patients with COPD older than 40 years...

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Autores principales: Chen, Cheng-Hsin, Lai, Chih-Cheng, Wang, Ya-Hui, 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/PMC6262552/
https://www.ncbi.nlm.nih.gov/pubmed/30373237
http://dx.doi.org/10.3390/jcm7110393
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author Chen, Cheng-Hsin
Lai, Chih-Cheng
Wang, Ya-Hui
Wang, Cheng-Yi
Wang, Hao-Chien
Yu, Chong-Jen
Chen, Likwang
author_facet Chen, Cheng-Hsin
Lai, Chih-Cheng
Wang, Ya-Hui
Wang, Cheng-Yi
Wang, Hao-Chien
Yu, Chong-Jen
Chen, Likwang
author_sort Chen, Cheng-Hsin
collection PubMed
description This study aims to identify the impact of new-onset sepsis in patients with chronic obstructive pulmonary disease (COPD) including the effects on acute exacerbations, pneumonia and mortality. Using the National Health Insurance Research Database of Taiwan, all patients with COPD older than 40 years between 1988 and 2010 were recruited. After propensity score matching, each of the 8774 COPD patients with and without sepsis were identified to have similar characteristics. The primary outcome was severe exacerbations of COPD, with a severe exacerbation being defined as a patient requiring hospital admission or an emergency department visit due to COPD. The secondary outcomes were pneumonia, serious pneumonia, and all-cause mortality. The post-index overall cumulative incidence rates of total acute exacerbations were 11.2/person-years in the sepsis group and 6.2/person-years in the non-sepsis group (adjusted hazard ratio (HR) = 1.38, 95% confidence interval (CI), 1.38–1.40). The sepsis group also had higher risks of severe exacerbations (adjusted HR = 2.05, 95% CI, 2.02–2.08), severe exacerbations requiring hospitalization (adjusted HR = 2.30, 95% CI, 2.24–2.36), and severe exacerbations leading to an emergency room visit (adjusted HR = 1.91, 95% CI, 1.87–1.94). Regarding the effect on secondary outcomes, the sepsis group had higher risks of mortality (incidence rate: 23.7/person-years vs. 11.34/person-years, adjusted HR = 2.27, 95% CI, 2.14–2.41), pneumonia (incidence rate: 26.41 per person-days vs. 10.34 per person-days, adjusted HR = 2.70, 95% CI, 2.5–2.91), and serious pneumonia (incidence rate: 5.84 per person-days vs. 1.98 per person-days, adjusted HR = 2.89, 95% CI, 2.5–3.33) compared with the non-sepsis group. Sepsis survivors among patients with COPD had a higher risk of severe exacerbations, pneumonia, serious pneumonia, and mortality compared to patients with COPD without sepsis.
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spelling pubmed-62625522018-12-03 The Impact of Sepsis on the Outcomes of COPD Patients: A Population-Based Cohort Study Chen, Cheng-Hsin Lai, Chih-Cheng Wang, Ya-Hui Wang, Cheng-Yi Wang, Hao-Chien Yu, Chong-Jen Chen, Likwang J Clin Med Article This study aims to identify the impact of new-onset sepsis in patients with chronic obstructive pulmonary disease (COPD) including the effects on acute exacerbations, pneumonia and mortality. Using the National Health Insurance Research Database of Taiwan, all patients with COPD older than 40 years between 1988 and 2010 were recruited. After propensity score matching, each of the 8774 COPD patients with and without sepsis were identified to have similar characteristics. The primary outcome was severe exacerbations of COPD, with a severe exacerbation being defined as a patient requiring hospital admission or an emergency department visit due to COPD. The secondary outcomes were pneumonia, serious pneumonia, and all-cause mortality. The post-index overall cumulative incidence rates of total acute exacerbations were 11.2/person-years in the sepsis group and 6.2/person-years in the non-sepsis group (adjusted hazard ratio (HR) = 1.38, 95% confidence interval (CI), 1.38–1.40). The sepsis group also had higher risks of severe exacerbations (adjusted HR = 2.05, 95% CI, 2.02–2.08), severe exacerbations requiring hospitalization (adjusted HR = 2.30, 95% CI, 2.24–2.36), and severe exacerbations leading to an emergency room visit (adjusted HR = 1.91, 95% CI, 1.87–1.94). Regarding the effect on secondary outcomes, the sepsis group had higher risks of mortality (incidence rate: 23.7/person-years vs. 11.34/person-years, adjusted HR = 2.27, 95% CI, 2.14–2.41), pneumonia (incidence rate: 26.41 per person-days vs. 10.34 per person-days, adjusted HR = 2.70, 95% CI, 2.5–2.91), and serious pneumonia (incidence rate: 5.84 per person-days vs. 1.98 per person-days, adjusted HR = 2.89, 95% CI, 2.5–3.33) compared with the non-sepsis group. Sepsis survivors among patients with COPD had a higher risk of severe exacerbations, pneumonia, serious pneumonia, and mortality compared to patients with COPD without sepsis. MDPI 2018-10-27 /pmc/articles/PMC6262552/ /pubmed/30373237 http://dx.doi.org/10.3390/jcm7110393 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
Chen, Cheng-Hsin
Lai, Chih-Cheng
Wang, Ya-Hui
Wang, Cheng-Yi
Wang, Hao-Chien
Yu, Chong-Jen
Chen, Likwang
The Impact of Sepsis on the Outcomes of COPD Patients: A Population-Based Cohort Study
title The Impact of Sepsis on the Outcomes of COPD Patients: A Population-Based Cohort Study
title_full The Impact of Sepsis on the Outcomes of COPD Patients: A Population-Based Cohort Study
title_fullStr The Impact of Sepsis on the Outcomes of COPD Patients: A Population-Based Cohort Study
title_full_unstemmed The Impact of Sepsis on the Outcomes of COPD Patients: A Population-Based Cohort Study
title_short The Impact of Sepsis on the Outcomes of COPD Patients: A Population-Based Cohort Study
title_sort impact of sepsis on the outcomes of copd patients: a population-based cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262552/
https://www.ncbi.nlm.nih.gov/pubmed/30373237
http://dx.doi.org/10.3390/jcm7110393
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