Background
Methods
Data source
Patient selection
Co-morbidities on admission
A-DROP score
Clinical outcomes
Statistical analysis
Results
Comparison of clinical characteristics between AsP and CAP in patients with COPD
AsP (n = 16,388) | CAP (n = 70,942) |
p
| |||
---|---|---|---|---|---|
Age (years) † | 82.7 ± 8.0 | 77.4 ± 9.5 | <0.001 | ||
40–64 | 426 | (2.6) | 7,318 | (10.3) | |
65–74 | 1,851 | (11.3) | 16,562 | (23.3) | |
75–84 | 6,935 | (42.3) | 30,759 | (43.4) | |
≥85 | 7,176 | (43.8) | 16,303 | (23.0) | |
Sex | <0.001 | ||||
Male | 13,328 | (81.3) | 58,815 | (82.9) | |
Female | 3060 | (18.7) | 12,127 | (17.1) | |
Body mass index (kg/m2)† | 18.5 ± 3.6 | 19.9 ± 3.8 | <0.001 | ||
<18.5 | 7,196 | (54.9) | 23,835 | (39.0) | |
18.5–24.9 | 5,338 | (40.7) | 31,964 | (52.3) | |
25.0–29.9 | 512 | (3.9) | 4,684 | (7.7) | |
>30 | 58 | (0.4) | 631 | (1.0) | |
Dyspnea scale | <0.001 | ||||
I | 562 | (3.8) | 6159 | (9.4) | |
II | 966 | (6.5) | 8,991 | (13.7) | |
III | 1,239 | (8.4) | 9,001 | (13.7) | |
IV | 2,509 | (16.9) | 16,277 | (24.8) | |
V | 4,284 | (28.9) | 16,885 | (25.7) | |
Unspecified | 5,273 | (35.5) | 8,348 | (12.7) | |
Level of consciousness | <0.001 | ||||
Alert | 10,233 | (62.5) | 60,993 | (86.0) | |
Dull | 4,048 | (24.7) | 7,220 | (10.2) | |
Somnolence | 1,379 | (8.4) | 1,610 | (2.3) | |
Coma | 724 | (4.4) | 1,116 | (1.6) | |
ADL level | <0.001 | ||||
20 | 1,633 | (11.2) | 23,281 | (37.8) | |
15–19 | 1,124 | (7.7) | 8,462 | (13.7) | |
10–14 | 1,614 | (11.1) | 9,887 | (16.0) | |
5–9 | 1,590 | (10.9) | 6,113 | (9.9) | |
0–4 | 8,598 | (59.1) | 13,927 | (22.6) | |
A-DROP score ‡ | <0.001 | ||||
Mild | 175 | (1.9) | 4,293 | (8.8) | |
Moderate | 4,833 | (53.7) | 31,067 | (63.6) | |
Severe | 2,352 | (26.1) | 9,630 | (19.7) | |
Extremely severe | 1,641 | (18.2) | 3,868 | (7.9) |
AsP | CAP |
p
| |||
---|---|---|---|---|---|
n = 16,388 | (%) | n = 70,942 | (%) | ||
Interstitial pneumonia | 357 | (2.2) | 3,619 | (5.1) | <0.001 |
Lung cancer | 728 | (4.4) | 6,983 | (9.8) | <0.001 |
Heart failure | 3,350 | (20.4) | 12,704 | (17.9) | <0.001 |
Ischemic heart disease | 998 | (6.1) | 4,619 | (6.5) | 0.048 |
Cardiac arrhythmia | 880 | (5.4) | 3,560 | (5.0) | 0.065 |
Pulmonary embolism | 31 | (0.2) | 206 | (0.3) | 0.025 |
Cor pulmonale | 110 | (0.7) | 806 | (1.1) | <0.001 |
Cerebrovascular disease | 2,816 | (17.2) | 3,992 | (5.6) | <0.001 |
Chronic liver disease | 171 | (1.0) | 1,102 | (1.6) | <0.001 |
Chronic renal failure | 345 | (2.1) | 1,525 | (2.1) | 0.723 |
Anxiety/depression | 227 | (1.4) | 1,025 | (1.4) | 0.562 |
Bone fracture | 353 | (2.2) | 812 | (1.1) | <0.001 |
Comparison of outcomes between AsP and CAP in patients with COPD
AsP (n = 16,388) | CAP (n = 70,942) |
p
| ||||
---|---|---|---|---|---|---|
Death | 3,726 | (22.7) | 8,671 | (12.2) | <0.001 | |
Length of stay (days) | 21.0 [12–40] | <0.001 | ||||
ICU admission | 522 | (3.2) | 2021 | (2.8) | 0.021 | |
Length of ICU stay (days) | 0.527 | |||||
Mechanical ventilation | 1,951 | (11.9) | 7,339 | (10.3) | <0.001 | |
Duration of mechanical ventilation (days) | 0.001 | |||||
Death† | 1,010 | (51.8) | 3,036 | (41.4) | <0.001 |
Multivariable logistic regression analysis for all-cause in-hospital mortality
All | AsP | CAP | |||||
---|---|---|---|---|---|---|---|
aOR | 95 % CI | aOR | 95 % CI | aOR | 95 % CI | ||
Type of pneumonia | |||||||
AsP | 1.19** | 1.08–1.31 | |||||
CAP | Ref. | ||||||
Age (years) | |||||||
40–64 | Ref. | Ref. | Ref. | ||||
65–74 | 1.13 | 0.93–1.38 | 1.43 | 0.75–2.71 | 1.09 | 0.87–1.35 | |
75–84 | 1.28* | 1.05–1.56 | 1.52 | 0.80–2.91 | 1.22 | 0.98–1.52 | |
>85 | 1.45** | 1.18–1.77 | 1.58 | 0.83–2.97 | 1.41** | 1.12–1.77 | |
Sex | |||||||
Male | Ref. | Ref. | Ref. | ||||
Female | 0.60** | 0.54–0.67 | 0.66** | 0.52–0.83 | 0.58** | 0.52–0.66 | |
Body mass index (kg/m2) | |||||||
<18.5 | 1.70** | 1.58–1.83 | 1.72** | 1.50–1.96 | 1.69** | 1.55–1.84 | |
18.5–24.9 | Ref. | Ref. | Ref. | ||||
25–29.9 | 0.77** | 0.65–0.93 | 0.73 | 0.48–1.12 | 0.77* | 0.63–0.95 | |
>30 | 0.88 | 0.56–1.38 | 0.79 | 0.24–2.55 | 0.90 | 0.52–1.47 | |
Dyspnea grade by Hugh-Jones classification | |||||||
I | Ref. | Ref. | Ref. | ||||
II | 1.23 | 0.89–1.68 | 0.64 | 0.33–1.22 | 1.42 | 1.00–2.02 | |
III | 1.51** | 1.13–2.01 | 0.90 | 0.51–1.58 | 1.68** | 1.21–2.34 | |
IV | 2.26** | 1.74–2.96 | 1.30 | 0.76–2.22 | 2.57** | 1.89–3.50 | |
V | 5.44** | 4.19–7.08 | 2.60** | 1.55–4.37 | 6.42** | 4.72–8.72 | |
Unspecified | 5.54** | 4.20–7.29 | 2.47** | 1.46–4.19 | 6.90** | 4.99–9.53 | |
Level of consciousness | |||||||
Alert | Ref. | Ref. | Ref. | ||||
Dull | 0.96 | 0.86–1.07 | 0.88 | 0.75–1.03 | 1.00 | 0.88–1.14 | |
Somnolence | 1.09 | 0.94–1.27 | 0.82 | 0.64–1.04 | 1.38** | 1.12–1.70 | |
Coma | 1.46** | 1.19–1.80 | 1.22 | 0.88–1.68 | 1.62** | 1.24–2.10 | |
Level of ADL scored by Barthel index | |||||||
20 | Ref. | Ref. | Ref. | ||||
15–19 | 1.26** | 1.09–1.45 | 1.07 | 0.73–1.59 | 1.26** | 1.07–1.48 | |
10–14 | 1.54** | 1.34–1.76 | 1.33 | 0.93–1.90 | 1.51** | 1.31–1.75 | |
5–9 | 1.90** | 1.65–2.20 | 1.22 | 0.85–1.75 | 1.99** | 1.69–2.35 | |
0–4 | 3.04** | 2.67–3.46 | 1.94** | 1.43–2.63 | 3.21** | 2.76–3.71 | |
A-DROP score | |||||||
Mild | Ref. | Ref. | Ref. | ||||
Moderate | 1.64** | 1.24–2.17 | 3.22* | 1.15–9.00 | 1.48* | 1.09–2.01 | |
Severe | 2.86** | 2.12–3.85 | 5.11** | 1.78–14.65 | 2.67** | 1.94–3.68 | |
Extremely severe | 7.84** | 5.74–10.70 | 14.18** | 4.85–41.41 | 7.22** | 5.15–10.12 | |
Co-morbidities on admission | |||||||
IP | 2.21** | 1.88–2.60 | 1.69* | 1.12–2.55 | 2.32** | 1.95–2.76 | |
Lung cancer | 2.80** | 2.45–3.20 | 1.88** | 1.40–2.52 | 3.00** | 2.59–3.48 | |
Heart failure | 1.16** | 1.06–1.27 | 1.27** | 1.06–1.53 | 1.14* | 1.00–1.24 | |
IHD | 0.80** | 0.69–0.93 | 0.93 | 0.69–1.25 | 0.76** | 0.63–0.90 | |
Arrhythmia | 1.15 | 0.99–1.33 | 1.34* | 1.01–1.78 | 1.07 | 8.9–.128 | |
PE | 0.91 | 0.44–1.90 | 1.20 | 0.11–12.56 | 0.84 | 0.40–1.75 | |
Cor pulmonale | 1.42* | 1.02–1.99 | 1.77 | 0.80–3.89 | 1.35 | 0.93–1.l97 | |
CVD | 0.94 | 0.84–1.06 | 0.99 | 0.84–1.16 | 0.92 | 0.79–1.07 | |
CLD | 1.23 | 0.93–1.64 | 1.51 | 0.81–2.81 | 1.13 | 0.81–1.57 | |
CRF | 1.65** | 1.35–2.02 | 1.56* | 1.08–2.27 | 1.68** | 1.35–2.09 | |
ANX/DEP | 0.90 | 0.64–1.28 | 1.53 | 0.92–2.53 | 0.67 | 0.43–1.05 | |
Bone fracture | 1.66** | 1.29–2.13 | 1.20 | 0.80–1.82 | 1.90** | 1.41–2.56 |