Table 2.
Cumulative risk of pleuropulmonary complications, 30-day mortality, and ICU admission according to baseline characteristics of the overall study cohort of patients with COPD and pneumonia.
| Patients with a pleuropulmonary complication | Patients deceased at 30 days | Patients admitted to ICU | Patients without any of these complications | |
|---|---|---|---|---|
| n = 315/11,368 (2.8%) | n = 1,211/11,368 (10.7%) | n = 403/6,165 (6.5%) | n = 5,057/6,165 (82.0%) | |
| Gender | ||||
| Female | 134 (2.5) | 522 (9.6) | 207 (6.9) | 2,488 (83.0) |
| Male | 181 (3.1) | 689 (11,6) | 196 (6.2) | 2,569 (82.1) |
| Age (years) | ||||
| Median [Q1–Q3] | 72.9 [64.3–79.7] | 79.3 [73.3–84.7] | 72.7 [64.6–79.7] | 75.3 [67.3–81.8] |
| 40–59 | 56 (4.8) | 47 (4.0) | 51 (7.7) | 558(86.2) |
| 60–79 | 186 (2.7) | 594 (8.7) | 255 (7.4) | 2,865 (84.2) |
| 80+ | 73 (2.2) | 570 (16.8) | 97 (4.7) | 1,634 (78.7) |
| COPD history | ||||
| Duration of COPD (months) | 27.7 [0.9–68.3] | 29.2 [3.6–68.5] | 20.7 [0.0–76.5] | 35.0 [2.7–83.8] |
| Duration of COPD ≤1 year* | 119 (2.8) | 422 (9.8) | 185 (8.8) | 1,707 (82.0) |
| Patients with frequent exacerbations# | 39 (2.1) | 208 (11.3) | 218 (5.3) | 933 (82.9) |
| Airflow limitation | ||||
| Gold 1 | 1 (2.9) | 3 (8.6) | 3 (8.6) | 30 (85.7) |
| Gold 2 | 9 (4.0) | 13 (5.7) | 10 (4.4) | 199 (89.2) |
| Gold 3 | 8 (2.4) | 33 (10.0) | 16 (4.9) | 277 (85.0) |
| Gold 4 | 4 (2.1) | 22 (11.3) | 17 (8.8) | 155 (79.9) |
| Gold unknown | 293 (2.8) | 1,140 (10.8) | 357 (6.6) | 4,396 (82.2) |
| Marital status | ||||
| Married | 144 (2.7) | 478 (8.9) | 193 (6.9) | 2,318 (83.7) |
| Never married | 30 (3.7) | 86 (10.6) | 36 (7.5) | 390 (83.0) |
| Divorced | 49 (3.3) | 128 (8.7) | 58 (6.8) | 707 (83.6) |
| Widowed | 92 (2.4) | 518 (13.8) | 116 (5.7) | 1,642 (80.6) |
| Unknown | 0 (0.0) | 1 (100.0) | 0 (0.0) | 0 (0.0) |
| Alcoholism-related disorders | 9 (4.2) | 20 (9.3) | 22 (15.9) | 104 (76.5) |
| Comorbidity | ||||
| Myocardal infarction | 32 (2.4) | 168 (12.8) | 41 (5.1) | 657 (81.7) |
| Congestive heart failure | 45 (2.2) | 300 (14.7) | 68 (6.6) | 809 (78.7) |
| Cerebrovascular disease | 48 (2.9) | 224 (13.7) | 59 (5.7) | 821 (79.6) |
| Diabetes | 29 (2.7) | 117 (10.8) | 51 (7.2) | 582 (82.8) |
| Renal disease | 16 (3.3) | 67 (13.8) | 25 (7.5) | 266 (79.9) |
| Liver disease | 10 (4.8) | 21 (10.0) | 10 (7.2) | 114 (83.8) |
| Cancer | 58 (3.2) | 279 (15.4) | 48 (4.2) | 917 (80.6) |
| AIDS | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (100.0) |
| Modified CCI score | ||||
| Low (0) | 119 (2.7) | 361 (8.0) | 170 (7.8) | 1837 (84.6) |
| Medium (1–2) | 133 (2.8) | 493 (10.6) | 159 (6.3) | 2065 (82.8) |
| High (3+) | 63 (2.8) | 357 (16.1) | 74 (5.0) | 1,155 (79.1) |
| Concurrent medication use‡ | ||||
| ICS | ||||
| Non-users | 115 (3.2) | 448 (12.6) | 142 (8.9) | 1,232 (77.7) |
| ICS current users | 156 (2.6) | 554 (9.1) | 207 (5.7) | 3,051 (84.6) |
| ICS former users | 44 (2.5) | 209 (12.1) | 54 (5.7) | 774 (82.4) |
| Inhaled bronchodilators | 205 (2.6) | 772 (9.9) | 272 (5.8) | 3,886 (84.0) |
| LAMA only or LABA only | 74 (2.1) | 315 (9.1) | 107 (5.5) | 1,667 (85.1) |
| LAMA & LABA | 79 (3.5) | 208 (9.2) | 122 (6.0) | 1,697 (84.1) |
| Systemic steroids† | 109 (2.3) | 540 (11.5) | 150 (6.0) | 2,052 (82.2) |
| Immunomodulating agents | ||||
| Immunosuppressants | 4 (2.6) | 11 (7.2) | 3 (2.3) | 115 (90.6) |
| Antineoplastic agents | 0 (0.0) | 8 (17.5) | 2 (22.2) | 6 (66.7) |
| Cardiometabolic drugs | ||||
| Platelet aggregation inhibitors | 92 (2.8) | 392 (11.8) | 152 (6.2) | 2,004 (80.2) |
| Vitamin K antagonists | 30 (3.1) | 121 (12.4) | 40 (5.7) | 573 (82.0) |
| Antiarrhythmics | 28 (1.8) | 258 (16.6) | 46 (6.3) | 570 (78.5) |
| Diuretics | 170 (2.6) | 826 (12.5) | 248 (6.7) | 3,001(81.2) |
| Beta blocking agents | 71 (3.4) | 219 (10.5) | 103 (6.3) | 1,329 (82.1) |
| Calcium channel blockers | 73 (3.1) | 236 (10.0) | 100 (6.7) | 1,232 (82.8) |
| Agents acting on the renin-angiotensin system | 90 (3.0) | 301 (10.2) | 150 (7.2) | 1,731 (83.1) |
| Other antihypertensive drugs | 0 (0.0) | 15 (12.2) | 7 (10.9) | 52 (81.3) |
| Insulin | 15 (3.6) | 40 (9.5) | 25 (9.0) | 229 (83.0) |
| Other glucose-lowering drugs | 22 (2.7) | 77 (9.3) | 43 (7.5) | 482 (84.4) |
| Statins | 60 (2.8) | 174 (8.2) | 124 (6.6) | 1,590 (84.8) |
| Proton pump inhibitors | 92 (3.1) | 348 (11.8) | 93 (4.5) | 1,712 (83.9) |
| Paracetamol | 124 (2.9) | 584 (13.6) | 152 (5.8) | 2,099 (80.4) |
| NSAIDs within 60 days | 49 (3.9) | 118 (9.4) | 55 (8.0) | 564 (83.1) |
| Antibiotics within 10 days | 73 (2.8) | 264 (10.2) | 90 (5.8) | 1,293 (83.9) |
| Macrolides | 24 (2.8) | 60 (6.9) | 32 (6.5) | 416 (85.4) |
| Penicillin V | 34 (2.7) | 122 (9.6) | 37 (5.3) | 583 (84.4) |
| Penicillin A | 11 (3.6) | 51 (16.9) | 8 (4.5) | 147 (84.0) |
| Penicillin A + enzyme inhibitor | 5 (1.9) | 35 (13.1) | 17 (6.4) | 217 (81.6) |
| Penicillin M | 0 (0.0) | 7 (13.7) | 1 (3.1) | 28 (87.5) |
| Tetracycline | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (100.0) |
| Fluoroquinolone | 0 (0.0) | 3 (17.6) | 0 (0.0) | 0 (0.0) |
Pleuropulmonary complications and death could be assessed in all 11,368 COPD patients with a first-time diagnosis of community-acquired pneumonia between 1997 and 2013; ICU risk could be assessed in 6,165 COPD patients between 2005 and 2013 when data on ICU admissions had become available in the Danish National Patient Registry. Data are presented as no. (%) except for age and duration of COPD [presented as median (Q1–Q3)]. AIDS, Acquired immune deficiency syndrome; CCI, Charlson Comorbidity Index; COPD, Chronic obstructive pulmonary disease; ICU, Intensive care unit; ICS, Inhaled corticosteroids; LABA, Long-acting beta agonists; LAMA, Long-acting muscarinic antagonists; NSAIDs, Non-steroidal anti-inflammatory drugs. ICS current users: persons who had filled their most recent prescription within 180 days prior to the index date. Former users: persons who had redeemed their most recent prescription ≥ 181 days before the index date. Non-users: persons with no redeemed ICS prescriptions before the index date. Modified CCI score: computed excluding chronic lung disease. *Duration of COPD: time elapsed between first occurrence of hospital-coded COPD and the index date. # Frequent exacerbations: ≥ 2 exacerbations with short-term courses of oral corticosteroids or ≥ 1 exacerbation leading to hospital admission during the previous year. ‡NSAID use within 60 days before hospital admission. Antibiotic use within 10 days before hospital admission. Other concurrent medications within 365 days prior to admission. †Systemic steroid use refers to at least one prescription for systemic steroids during the year before the index date (chronic or occasional use, indication not available in the registry).