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Early readmission and mortality in acute exacerbation of chronic obstructive pulmonary disease with community-acquired pneumonia

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are important causes of hospital admission and mortality. Pneumonia is a major contributor to hospitalization for AECOPD and has a close relationship with poor outcomes. We performed a prospective cohort study to evaluate the prog...

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Autores principales: Shin, Beomsu, Kim, Sang-Ha, Yong, Suk Joong, Lee, Won-Yeon, Park, Sunmin, Lee, Sang Jun, Lee, Seok Jeong, Lee, Myoung Kyu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301835/
https://www.ncbi.nlm.nih.gov/pubmed/30428701
http://dx.doi.org/10.1177/1479972318809480
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author Shin, Beomsu
Kim, Sang-Ha
Yong, Suk Joong
Lee, Won-Yeon
Park, Sunmin
Lee, Sang Jun
Lee, Seok Jeong
Lee, Myoung Kyu
author_facet Shin, Beomsu
Kim, Sang-Ha
Yong, Suk Joong
Lee, Won-Yeon
Park, Sunmin
Lee, Sang Jun
Lee, Seok Jeong
Lee, Myoung Kyu
author_sort Shin, Beomsu
collection PubMed
description Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are important causes of hospital admission and mortality. Pneumonia is a major contributor to hospitalization for AECOPD and has a close relationship with poor outcomes. We performed a prospective cohort study to evaluate the prognosis of AECOPD patients with or without community-acquired pneumonia (CAP) who hospitalized from January 2012 to December 2015. We investigated mortality and readmission rates within 6 months after the first admission between two groups and analyzed the difference of survival rate according to readmission duration (≤30 vs. >30 days) or intensive care unit (ICU) treatment. Total 308 AECOPD patients (134 with CAP and 174 without CAP) were enrolled. The mean age was 72.3 ± 9.5 years old, and 235 patients (76.3%) were male. The 180-day mortality was higher in AECOPD with CAP than without CAP (24.6% vs. 13.2%; hazard ratio (HR): 1.982; 95% CI: 1.164–3.375; p = 0.012). However, readmission rate showed no significant difference between two groups (51.5% vs. 46.6%; HR: 1.172; 95% CI: 0.850–1.616; p = 0.333). It showed a significantly lower survival rate in AECOPD with CAP rather than without CAP when were readmitted within 30 days (HR: 1.738; 95% CI:1.063–3.017; p = 0.031). According to ICU treatment, survival rate was not significantly different between two groups. Multivariate analysis revealed the readmission within 30 days (p  <  0.001), serum hemoglobin concentration (p  =  0.010), and albumin level (p =  0.049) were significantly associated with 180-day mortality of AECOPD with CAP. AECOPD with CAP showed lower survival rate than AECOPD without CAP during 6 months. Early readmission within 30 days was significantly associated with an increased risk of mortality.
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spelling pubmed-63018352019-01-24 Early readmission and mortality in acute exacerbation of chronic obstructive pulmonary disease with community-acquired pneumonia Shin, Beomsu Kim, Sang-Ha Yong, Suk Joong Lee, Won-Yeon Park, Sunmin Lee, Sang Jun Lee, Seok Jeong Lee, Myoung Kyu Chron Respir Dis Original Paper Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are important causes of hospital admission and mortality. Pneumonia is a major contributor to hospitalization for AECOPD and has a close relationship with poor outcomes. We performed a prospective cohort study to evaluate the prognosis of AECOPD patients with or without community-acquired pneumonia (CAP) who hospitalized from January 2012 to December 2015. We investigated mortality and readmission rates within 6 months after the first admission between two groups and analyzed the difference of survival rate according to readmission duration (≤30 vs. >30 days) or intensive care unit (ICU) treatment. Total 308 AECOPD patients (134 with CAP and 174 without CAP) were enrolled. The mean age was 72.3 ± 9.5 years old, and 235 patients (76.3%) were male. The 180-day mortality was higher in AECOPD with CAP than without CAP (24.6% vs. 13.2%; hazard ratio (HR): 1.982; 95% CI: 1.164–3.375; p = 0.012). However, readmission rate showed no significant difference between two groups (51.5% vs. 46.6%; HR: 1.172; 95% CI: 0.850–1.616; p = 0.333). It showed a significantly lower survival rate in AECOPD with CAP rather than without CAP when were readmitted within 30 days (HR: 1.738; 95% CI:1.063–3.017; p = 0.031). According to ICU treatment, survival rate was not significantly different between two groups. Multivariate analysis revealed the readmission within 30 days (p  <  0.001), serum hemoglobin concentration (p  =  0.010), and albumin level (p =  0.049) were significantly associated with 180-day mortality of AECOPD with CAP. AECOPD with CAP showed lower survival rate than AECOPD without CAP during 6 months. Early readmission within 30 days was significantly associated with an increased risk of mortality. SAGE Publications 2018-11-14 /pmc/articles/PMC6301835/ /pubmed/30428701 http://dx.doi.org/10.1177/1479972318809480 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Paper
Shin, Beomsu
Kim, Sang-Ha
Yong, Suk Joong
Lee, Won-Yeon
Park, Sunmin
Lee, Sang Jun
Lee, Seok Jeong
Lee, Myoung Kyu
Early readmission and mortality in acute exacerbation of chronic obstructive pulmonary disease with community-acquired pneumonia
title Early readmission and mortality in acute exacerbation of chronic obstructive pulmonary disease with community-acquired pneumonia
title_full Early readmission and mortality in acute exacerbation of chronic obstructive pulmonary disease with community-acquired pneumonia
title_fullStr Early readmission and mortality in acute exacerbation of chronic obstructive pulmonary disease with community-acquired pneumonia
title_full_unstemmed Early readmission and mortality in acute exacerbation of chronic obstructive pulmonary disease with community-acquired pneumonia
title_short Early readmission and mortality in acute exacerbation of chronic obstructive pulmonary disease with community-acquired pneumonia
title_sort early readmission and mortality in acute exacerbation of chronic obstructive pulmonary disease with community-acquired pneumonia
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301835/
https://www.ncbi.nlm.nih.gov/pubmed/30428701
http://dx.doi.org/10.1177/1479972318809480
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