Patients were censored when they switched to the other fixed combination and when they left the study because of death or immigration. Pneumonia is dangerous, because it reduces the amount of oxygen in the body. Yearly data for the pneumonia event rate for the unmatched populations showed a rate ratio of 1.76 (1.63 to 1.89) in patients treated with fluticasone/salmeterol versus budesonide/formoterol. We carried out an observational retrospective cohort study, matched for propensity score, linking primary care medical records to data from national mandatory Swedish registries. p values were from Mann-Whitney U test. The propensity score method has previously been used to reduce potential confounding caused by unbalanced covariates.19 20 The matching starts with the smallest population (2738 patients in the fluticasone/salmeterol group) and matches 1:1 to the larger treatment group. We used pairwise 1:1 propensity score matching (greedy 5-to-1 digit matching without replacement),18 including logistic regression, to reduce concerns related to non-random assignment of patients to treatments. … It is unclear whether concurrent pneumonia and chronic obstructive pulmonary disease (COPD) have a higher mortality than either condition alone. In this observational retrospective matched cohort study patients with chronic obstructive pulmonary disease (COPD) who were treated with fluticasone/salmeterol were significantly more likely to experience pneumonia and had a higher mortality related to pneumonia … Wiley Series in Probability and Statistics. Mortality (A) and cumulative number of confirmed cases of COVID-19 since the start of the outbreak per 10 000 population (B) in Hubei and other provinces of China. Relevant anonymised patient level data are available on reasonable request from the authors. This is in contrast to patients either referred to hospital with COPD or diagnosed with COPD at hospitals, who are more likely to suffer from more severe COPD. KL has also received unrestricted research grants from AstraZeneca, Boehringer Ingelheim, and GlaxoSmithKline. The statistical analysis plan was agreed on by the study steering committee, and data analysis was performed by the study database owner in collaboration with AstraZeneca. The mean duration of admission for pneumonia was similar in both groups (fluticasone/salmeterol 6.5 (SD 6.6) v budesonide/formoterol 7.1 (SD 7.2) days; P=0.12). Similarly, admission to hospital related to pneumonia was 74% higher in the fluticasone/salmeterol treatment group than the budesonide/formoterol group (rate ratio 1.74, 1.56 to 1.94; P<0.001; NNT=34, 24 to 59), with a corresponding 82% increase in days in hospital (53 v 29 days per 100 patient years, respectively; P<0.001; table 2⇓). How old were the people who died from COPD in 2012? In contrast, hospital-acquired pneumonia (HAP) is seen in patients who have recently visited a hospital or who live in long-term care facilities. Cox survival curve showing proportion of surviving hospitalised community-acquired pneumonia patients by the presence (-----; n = 215) or absence (––––; n = 529) of chronic obstructive pulmonary disease after adjusting for other potential confounders. Bacter… Definitive and presumptive causes were combined for reporting purposes. The difference remained when we included the beclometasone diproprionate equivalent dose as a covariate in the Poisson regression. Most diagnoses, however, were recorded at hospitals where radiography is a standard procedure.24 A subanalysis of these patients showed that the increased risk of pneumonia with fluticasone/salmeterol versus budesonide/formoterol was unchanged. The PSI is a validated prediction rule for 30-day mortality in patients with CAP 10. Pneumonia is a serious complication of COPD. All authors analysed and interpreted the data, revised the manuscript, had access to complete study data, and had authority over manuscript preparation, approval of final version and the decision to submit for publication. Hospital mortality increased sharply after the 60 s, reaching 38.5% after the 90 s. Most of the patients admitted to hospital for pneumonia were male 18,925 (52%). PSI and processes of care) 10 or a p-value of <0.10 in the univariate analyses. Mortality related to pneumonia was defined as mortality with ICD-10 code J10-J18 stated as the underlying cause or contributing to the cause of death in the cause of death registry. In addition, COPD patients with CAP showed higher rates of congestive heart failure and a history of neoplastic disease. The Cox survival curve shows the variation in mortality from the initiation of the hospitalisation to 30 and 90 days for patients with and without COPD (fig. There were no significant differences among the LAMA/LABA combinations in terms of the number of moderate to severe exacerbations, all-cause mortality, major adverse cardiovascular events, or pneumonia. What happens when you die of copd or pneumonia? When two or more microbiological causes were present, the cause was classified as polymicrobial pathogens. Therefore, it is important to recognise COPD in patients with CAP so that they may receive appropriate antimicrobial therapy. Methods 795 patients of the Cohort of Mortality and Inflammation in COPD (COMIC) study were divided into statin users or not. Please note: your email address is provided to the journal, which may use this information for marketing purposes. However, the present authors do not feel that this study has significant problems with either of these biases, due to the methods involving admission and discharge diagnosis ICD-9 codes to identify patients and the fact that only a small amount of missing data was encountered. Contributors: All authors participated equally in the study conception, design, and statistical analysis planning. In addition, hospitalised CAP patients with COPD exhibit significantly higher rates of ICU admission and a longer length of hospital stay compared with those without COPD. Pneumonia is an important complication of COPD and is reported more often in patients receiving inhaled corticosteroids (ICSs). Additionally, respiratory complications can increase risks of postoperative morbidity and mortality in … Of beclometasone diproprionate.23 aggressive than viral develop CAP not unlike those of any other type of pneumonia in with... 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