Inhaled corticosteroids and risk of pneumonia in newly diagnosed COPD
Inhaled corticosteroids and risk of pneumonia in newly diagnosed COPD
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DOI：
10.1016/j.rmed.2009.10.002
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发表时间：
2010-02-01
影响因子：
4.3
通讯作者：
Lee, Todd A.
中科院分区：
文献类型：
--
作者：
Joo, Min J.;Au, David H.;Lee, Todd A.
引言：COPD患者使用吸入性皮质类固醇（ICS）可能与肺炎风险增加相关。对于新诊断的COPD患者的这种风险知之甚少。本研究的目的是确定新诊断的COPD患者中使用ICS是否与肺炎住院的风险增加有关。方法：使用退伍军人事务部和医疗保险和医疗补助服务中心的数据，进行巢式病例对照研究。我们确定了1998年至2002年65岁或以上新诊断为COPD的患者。共识别了145，586名患者。病例定义基于因肺炎住院，暴露为既往使用ICS。每个病例根据年龄、性别、月份和年份匹配多达10个对照。ICS的使用和肺炎之间的关联进行了评估，条件Logistic回归控制年龄，合并症，与肺炎的风险，COPD严重程度的标志物相关的药物类别。该队列主要为男性，平均年龄为75.1（SD = 5.4）岁。肺炎的发病率为6.4/100人年。调整协变量后，目前使用ICS的患者比目前未使用ICS的患者因肺炎住院的可能性高1.38倍（95%CI，1.31-1.45）。结论：新诊断的COPD患者使用ICS与因肺炎住院的风险增加相关。爱思唯尔有限公司出版
Introduction: The use of inhaled corticosteroids (ICS) in COPD may be associated with an increased risk of pneumonia. Little is known of this risk in newly diagnosed COPD patients. The objective of this study was to determine if the use of ICS among newly diagnosed COPD patients is associated with an increased risk of pneumonia hospitalizations.Methods: Using data from the Department of Veterans Affairs and Centers for Medicare and Medicaid Services, a nested case-control study was performed. We identified patients 65 years of age or older with a new diagnosis of COPD from 1998 to 2002. A total of 145,586 patients were identified. Cases were defined based on hospitalization for pneumonia and exposure was prior use of ICS. Up to 10 controls were matched for each case based on age, sex, month and year of the case. The association between ICS use and pneumonia was evaluated with conditional logistic regression controlling for age, comorbidities, medication classes associated with the risk of pneumonia, and markers of COPD severity.Results: There were 13,995 cases of pneumonia. The cohort was predominantly mate with an average age of 75.1 (SD = 5.4) years. The rate of pneumonia was 6.4 per 100 person-years. After adjustment for covariates, patients with current use of ICS were 1.38 (95% CI, 1.31-1.45) times more likely to have a hospitalization for pneumonia than those without current use of ICS.Conclusions: The use of ICS among patients with newly diagnosed COPD is associated with an increased risk of hospitalization for pneumonia. Published by Elsevier Ltd.