Assessing the Impact of Gender and COPD on the Incidence and Mortality of Hospital-Acquired Pneumonia. A Retrospective Cohort Study Using the Spanish National Discharge Database (2016–2019)

Abstract

Background: We aim to analyze incidence and outcomes of patients hospitalized with hospital-acquired pneumonia (HAP) according to chronic obstructive pulmonary disease (COPD) status and sex in Spain (2016–2019). Methods: We conducted a retrospective cohort study using national hospital discharge data of patients ≥40 years with a primary diagnosis of HAP, using the specific diagnostics of non-ventilator (NV)-HAP and ventilator-associated pneumonia (VAP). Results: We identified 37,029 patients with HAP ((NV)-HAP 87.28%, VAP 12.72%), 13.40% with COPD. HAP incidence increased over time, but only in subjects without COPD (p < 0.001). In women, incidence of HAP and (NV)-HAP was similar regardless of COPD status, but VAP incidence was lower in COPD women (p = 0.007). In men, the incidence of (NV)-HAP was significantly higher in those with COPD, while VAP incidence was lower in COPD men (p < 0.001). The in-hospital mortality (IHM) was similar in men and women with and without COPD. The risk of dying in hospital increased with age, congestive heart failure, cancer, and dialysis among men and women with COPD. Men that underwent surgery had a lower risk of IHM. VAP increased 2.58-times the probability of dying in men and women. Finally, sex was not associated with IHM among COPD patients. Conclusions: Incidence of HAP was significantly higher in COPD patients than in those without COPD, at the expense of (NV)-HAP but not of VAP. When stratifying by sex, we found that the difference was caused by men. IHM was similar in COPD and non-COPD patients, with no significant change overtime. In addition, sex was not associated with IHM.

Predictors of hospital mortality and multidrug-resistant pathogens in hospitalized pneumonia patients residing in the community

“…Non-ambulatory status and COPD have also been shown to be risk factors in previous studies [ 33 ]. In our study, COPD grade showed a clear dose-response association with MDR pneumonia development; therefore, the association may be robust [ 34 , 35 ]. Being underweight and having bedsores are indications of malnutrition in patients, making them prone to infection with MDR pathogens.…”

Sex differences in factors influencing hospital-acquired pneumonia in schizophrenia patients receiving modified electroconvulsive therapy

“…Sex differences in the incidence of HAP exist ( 31 ), with men being a risk factor for HAP ( 32 , 33 ), but a lower incidence of non-ventilator HAP in women ( 34 ). Some pathologies may be explained by these differences induced by genders, such as immune response to the virus ( 24 ), diabetes ( 35 ), or chronic obstructive pulmonary disease (COPD) ( 36 ). However, there are few studies on gender differences in risk factors related to hospital-acquired pneumonia (HAP) in SCZ patients with mECT around the world.…”

Efficacy of Acupuncture on Quality of Life, Functional Performance, Dyspnea, and Pulmonary Function in Patients with Chronic Obstructive Pulmonary Disease: Protocol for a Randomized Clinical Trial

“…Although COPD compromises the lungs, it also has significant systemic consequences [ 1 , 4 , 5 , 6 ]. COPD patients often adopt a sedentary lifestyle that can precipitate the onset of muscle deconditioning through inactivity and a cycle of clinical deterioration [ 1 , 7 , 8 , 9 ], negatively impacting the quality of life of patients with COPD [ 1 , 10 ].…”