Risk factors for community-acquired pneumonia diagnosed upon hospital admission

Farr, Barry M.; Bartlett, C. L. R.; Wadsworth, J; Miller, David L.

doi:10.1053/rmed.2000.0865

Cited by 139 publications

(149 citation statements)

References 34 publications

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“…This conclusion is reinforced by the observation that the occurrence of pneumonia in patients prescribed antidepressants did not deviate from the expected wintertime peak in incidence. In addition to following up a potential signal, and in the process providing reassurance about the safety of antidepressants with regard to pneumonia in the elderly, this study confirms earlier findings that increasing age and the presence of comorbidities are strongly associated with pneumonia [13][14][15][16][17].…”

Section: Discussionsupporting

confidence: 87%

Observed association between antidepressant use and pneumonia risk was confounded by comorbidity measures

Hennessy¹,

Bilker²,

Leonard³

et al. 2007

Journal of Clinical Epidemiology

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Objective-A prior study suggested that antidepressants might increase the risk of hospitalization for pneumonia in the elderly. This study sought to confirm or refute this hypothesis.Study Design and Setting-Case-control study of persons age 65 and above nested in the UK General Practice Research Database.Results-We identified 12,044 cases of the hospitalization for pneumonia (the primary outcome) and 48,176 controls. The odds ratio (OR) for any antidepressant use, adjusting for age, sex, and calendar year was 1.61 (95% confidence interval 1.46 to 1.78). After further adjustment for comorbidity measures, the OR was 0.89 (0.79 to 1.00). We also identified 159 cases of hospitalization for aspiration pneumonia (the secondary outcome) and 636 controls. The OR for any antidepressant use, adjusted for age, sex, and calendar year was 1.45 (0.65 to 3.24). After further adjustment for comorbidity measures, the OR was 0.63 (0.23 to 1.71).Conclusion-These findings refute the prior hypothesis that use of antidepressants by elderly patients increases the risk of hospitalization for pneumonia or for aspiration pneumonia. Decisions regarding use of antidepressants in elderly persons should not be affected by concern about pneumonia risk. Data-derived hypotheses should be independently confirmed before being acted upon.

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Section: Discussionsupporting

confidence: 87%

Observed association between antidepressant use and pneumonia risk was confounded by comorbidity measures

Hennessy¹,

Bilker²,

Leonard³

et al. 2007

Journal of Clinical Epidemiology

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“…Steroid exposure has rarely been addressed as a potential risk factor for pneumonia in the general population (38)(39)(40)(41)44). To our knowledge, glucocorticoid dosage has not been demonstrated to be predictive of pneumonia risk in any previous study.…”

Section: Discussionmentioning

confidence: 79%

“…Among these factors is preexisting pulmonary disease, which has been shown in more than 20 studies to greatly increase the risk of pneumonia (38)(39)(40)(41). The pathophysiologic explanation for this finding is, however, incompletely understood.…”

Section: Discussionmentioning

confidence: 99%

Treatment for rheumatoid arthritis and the risk of hospitalization for pneumonia: Associations with prednisone, disease‐modifying antirheumatic drugs, and anti–tumor necrosis factor therapy

Wolfe¹,

Caplan²,

Michaud³

2006

Arthritis & Rheumatism

426

233

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Objective. Pneumonia is a major cause of mortality and morbidity in rheumatoid arthritis (RA). This study was undertaken to determine the rate and predictors of hospitalization for pneumonia and the extent to which specific RA treatments increase pneumonia risk.Methods. RA patients (n ‫؍‬ 16,788) were assessed semiannually for 3.5 years. Pneumonia was confirmed by medical records or detailed patient interview. Covariates included RA severity measures, diabetes, pulmonary disease, and myocardial infarction. Cox proportional hazards regression was used to determine the multivariable risk associated with RA treatments.Results Conclusion. There is a dose-related relationship between prednisone use and pneumonia risk in RA. No increase in risk was found for anti-tumor necrosis factor therapy or methotrexate. These data call into question the belief that low-dose prednisone is safe. Because corticosteroid use is common in RA, the results of this study suggest that prednisone exposure may have important public health consequences.

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“…La Sociedad Americana de Tórax (American Thoracic Society-ATS) no excluye de esta clasificación a los pacientes procedentes de ambientes institucionalizados, como casas de reposo o centros geriátricos, quienes presentan mayor riesgo de complicaciones y muerte 7 . Sin embargo, el diagnóstico de NAC puede presentar grados variables de heterogeneidad, lo que dificulta su análisis temporal y comparativo al utilizarse diferentes definiciones operacionales de la infección pulmonar 8 .…”

Section: Definición Operacionalunclassified

“…Examinando el riesgo individual, se ha comunicado hasta 1,8 veces más riesgo de neumonía en fumadores habituales comparados con la población no fumadora, observándose además una tendencia positiva en relación a la duración del hábito 7,17 . La cesación del hábito tabáquico reduciría el riesgo de neumonía hasta en un 50% después de 5 años.…”

Section: Tabaquismounclassified

Epidemiología de la neumonía del adulto adquirida en la comunidad

Valdívia

2005

Rev. chil. infectol.

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Respiratory diseases represent the third cause of death in Chilean population, after cardiovascular diseases and malignancy. Fifty percent of deaths caused by respiratory diseases in adults are attributable to pneumonia. In Chile, they represent the main cause of death due to infectious diseases and the first specific one in senescent adults over 80 years old. The incidence and mortality of community acquired pneumonia (CAP) increase in both extreme ages of life (less than one year old and over 65 years old). In the population over 65 years old, mortality is extremely increased, rising to rates of 6.6 deaths per 1.000 inhabitants. High variability in pneumonia hospitalization rate has been observed in different geographic areas, probably due to different medical criteria used to evaluate the severity of illness, access to healthcare systems and characteristics of the evaluated population. About 20% of patients affected with CAP require hospitalization due to the severity of pulmonary infection and to the risk of complications or death, and the necessity of healthcare resources are focused in these patients. Several clinical-epidemiological parameters able to modify clinical presentation and severity of pneumonia have been identified, such as advanced age, presence of co-morbidities, host immune competence, tobacco and alcohol consumption, place of acquiring the infection, etiology and environmental pollution.Key words: pneumonia, epidemiology, morbidity, mortality. Palabras clave: neumonía, epidemiología, morbilidad, mortalidad.Rev Chil Infect 2005; 22 (Supl 1): S11-S17Departamento de Salud Pública, Facultad de Medicina. Pontificia Universidad Católica de Chile, Santiago, Chile. Magnitud del problemaDesde hace 15 años, las enfermedades respiratorias constituyen una de las principales causas de muerte de la población chilena, siendo sólo superadas por las enfermedades del aparato circulatorio y los tumores malignos 1 [II]. Durante el año 2000, las enfermedades respiratorias fueron responsables del 10,5% de las muertes comunicadas en el país, con un volumen de 8.287 defunciones. La mortalidad por enfermedades respiratorias en la población adulta fue 3,2 veces superior a la observada en la población infantil, con una tasa específica de 54,4 defunciones por cada 100.000 habitantes 1 . La categoría diagnóstica de neumonía concentra el 50% de las muertes por enfermedades respiratorias en el adulto, elevándose al 82% en la población pediátrica 1 .Como causa específica de muerte, la neumonía (entidad diagnóstica que corresponde a las categorías comprendidas entre los códigos J12 y J18 de la Clasificación Internacional de Enfermedades, 10a revisión) 2 constituyó la principal causa de muerte en el 5,4% de los pacientes fallecidos en nuestro país (4.283 muertes por neumonía) 3 . El 97% de los casos fatales correspondió a neumonías en las que no hubo identificación del agente causal del cuadro respiratorio (J18: neumonía, organismo no especificado) 1-3 . La identificación del agente causal en la minoría de los casos, confir...

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Risk factors for community-acquired pneumonia diagnosed upon hospital admission

Cited by 139 publications

References 34 publications

Observed association between antidepressant use and pneumonia risk was confounded by comorbidity measures

Observed association between antidepressant use and pneumonia risk was confounded by comorbidity measures

Treatment for rheumatoid arthritis and the risk of hospitalization for pneumonia: Associations with prednisone, disease‐modifying antirheumatic drugs, and anti–tumor necrosis factor therapy

Epidemiología de la neumonía del adulto adquirida en la comunidad

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