Risk of pneumonia in patients with gastroesophageal reflux disease: A population-based cohort study

Hsu, Wei Hsuan; Lai, Chih‐Cheng; Wang, Yahui; Tseng, Ping‐Huei; Wang, Kun; Chen, Ming-Fong; Chen, Likwang

doi:10.1371/journal.pone.0183808

Cited by 44 publications

(31 citation statements)

References 21 publications

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“…The patients with pneumonia were identified according to the International Classification of Diseases, Ninth Revision, Clinical Modification codes as previously described. 5 , 17 For patients with more than one episode of pneumonia, only the first episode was included. A severe exacerbation was defined as a COPD-related hospitalization or emergency department visit.…”

Section: Methodsmentioning

confidence: 99%

Comparative effects of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on the risk of pneumonia and severe exacerbations in patients with COPD

Lai

Wang

Chen

et al. 2018

COPD

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ObjectivesThis study aimed to compare the effects of angiotensin-converting-enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) on the risk of pneumonia and severe exacerbations in patients with COPD.Patients and methodsAll patients with COPD who used ACEis and ARBs for >90 days between 2000 and 2005 were recruited. Pairwise matching (1:1) of the ACEi and ARB groups resulted in two similar subgroups, with 6,226 patients in each. The primary outcomes were pneumonia and COPD exacerbations, and the secondary outcome was death.ResultsDuring the follow-up period, the incidence of pneumonia was 7.20 per 100 person-years in the ACEi group and 5.89 per 100 person-years in the ARB group. The ACEi group had a higher risk of pneumonia (adjusted hazard ratio [aHR], 1.22; 95% CI, 1.15–1.29) than the ARB group. The incidence of severe exacerbations was 0.65 per person-year for the patients receiving ACEis and 0.52 per person-year for those receiving ARBs. The patients receiving ACEis had a higher risk of severe exacerbations (aHR, 1.19; 95% CI, 1.16–1.21) than those receiving ARBs. Similar trends were noted in terms of severe exacerbations requiring hospitalization (aHR, 1.24; 95% CI, 1.21–1.28) or emergency department visits (aHR, 1.16; 95% CI, 1.13–1.18), pneumonia requiring mechanical ventilation (aHR, 1.35; 95% CI, 1.24–1.47), and mortality (aHR, 1.33; 95% CI, 1.26–1.42).ConclusionARBs were associated with lower rates of pneumonia, severe pneumonia, and mortality than ACEis in patients with COPD.

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Section: Methodsmentioning

confidence: 99%

Comparative effects of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on the risk of pneumonia and severe exacerbations in patients with COPD

Lai

Wang

Chen

et al. 2018

COPD

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“…Another study demonstrated that cardiovascular function declined in elderly patients with heart disease, which would affect the mucociliary clearance functions that trap and remove particulates and pathogens from the airways, leading to an increased risk of incident pneumonia [ 35 ]. Furthermore, a population-based cohort study indicated that GERD is associated with a long-term risk of pneumonia, especially in GERD with proton pump inhibitors (PPIs) for a longer treatment than four months [ 36 ]. There is a relationship between gastric acid suppressants and an increased risk of pneumonia [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Anticholinergic Drugs and Correlation with Pneumonia in Elderly Patients: A Population-Based Study in Taiwan

Lee

Cheng

et al. 2020

IJERPH

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Anticholinergic drugs may increase the risk of serious respiratory infection, especially in the elderly. The study aims to investigate the prevalence of anticholinergic drugs and the correlation of incident pneumonia associated with the use of anticholinergic drugs among the elderly in Taiwan. The study population was 275,005 elderly patients aged ≥65 years old, selected from the longitudinal health insurance database (LHID) in 2016. Among all the elderly patients, about 60% had received anticholinergic medication at least once. Furthermore, the study selected elderly patients who had not been diagnosed with pneumonia and had not received any anticholinergic drugs in the past year in order to evaluate the correlation between pneumonia and anticholinergic drugs. The study excluded elderly patients who died or had received related drugs of incident pneumonia during the study period and selected elderly patients receiving anticholinergic drugs as the case group. Propensity score matching (PSM) on a 1:1 scale was used to match elderly patients that were not receiving any anticholinergic drugs as the control group, resulting in a final sample of 32,215 patients receiving anticholinergic drugs and 32,215 patients not receiving any anticholinergic drugs. Conditional logistic regression was used to estimate the association between anticholinergic drugs and pneumonia after controlling for potential confounders. Compared with patients not receiving anticholinergic drugs, the adjusted odds ratio of patients receiving anticholinergic drugs was 1.33 (95% confidence interval: 1.18 to 1.49). Anticholinergic medication is common among elderly patients in Taiwan. Elderly patients receiving anticholinergic drugs may increase their risk of incident pneumonia. The safety of anticholinergic drugs in the elderly should be of concern in Taiwan.

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“…DM in both cases and controls was assessed on the basis of at least three outpatient claims or at least one inpatient claim of ICD-9 Code 250.xx. Other medical conditions potentially associated with acute epiglottitis, including asthma (ICD-9-CM code: 493.xx), chronic liver disease and cirrhosis (ICD-9-CM code: 571.xx), coronary artery disease (ICD-9-CM codes: 410–414), hypertension (ICD-9-CM codes: 401–405), and pneumonia and influenza (ICD-9-CM codes: 480–488), upper digestive tract cancer (ICD-9-CM codes: 141–151), autoimmune diseases (ICD-9-CM codes: 714.0, 720, 720.0, 710.0, 370.33, 710.2, 710.1), chronic obstructive pulmonary disease (COPD, ICD-9-CM codes: 490–496), alcohol dependence and abuse (ICD-9-CM codes: 303, 303.xx, 305.0, 305.0x), corrosive injury of upper digestive tract (ICD-9-CM codes: 947.0–947.3), and gastroesophageal reflux disease (GERD, ICD-9-CM codes: 530.11, 530.81,530.85) were also assessed from the claims data[ 11 , 13 , 15 , 26 , 27 , 33 – 37 ]. We included these comorbidities if they occurred either in the inpatient setting or in more than three ambulatory care claims.…”

Section: Methodsmentioning

confidence: 99%

Risk of acute epiglottitis in patients with preexisting diabetes mellitus: A population-based case–control study

et al. 2018

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ObjectiveStudies have revealed that 3.5%–26.6% of patients with epiglottitis have comorbid diabetes mellitus (DM). However, whether preexisting DM is a risk factor for acute epiglottitis remains unclear. In this study, our aim was to explore the relationship between preexisting DM and acute epiglottitis in different age and sex groups by using population-based data in Taiwan.MethodsWe analyzed data between January 2000 and December 2013 obtained from the Taiwan National Health Insurance Research Database. The case group consisted of 2,393 patients with acute epiglottitis. The control group comprised 9,572 individuals without epiglottitis, frequency matched by sex, age, urbanization level, and income. Underlying DM was retrospectively assessed in the cases and controls. Univariate and multivariate logistic regression analyses were used to investigate the associations between underlying DM and acute epiglottitis.ResultsOf the 2,393 patients, 180 (7.5%) had preexisting DM, whereas only 530 (5.5%) of the 9,572 controls had preexisting DM. Multivariate logistic regression analyses indicated that preexisting DM was significantly associated with acute epiglottitis (adjusted odds ratio [aOR] = 1.42, 95% confidence interval [CI] = 1.15–1.75, P = 0.004). Subgroup analysis showed that the association between DM and epiglottitis remained significant for men (aOR = 1.57, 95% CI: 1.19–2.08, p = 0.002) but not for women. Age-stratified analysis revealed a significant association between DM and acute epiglottitis in patients aged 35–64 years. Use of anti-diabetic agents was not significantly associated with the development of acute epiglottitis among diabetic patients, including oral hypoglycemic agents (OHA) alone (aOR = 0.88, 95% CI = 0.53–1.46, p = 0.616), and OHA combined with insulin/ insulin alone (aOR = 1.30, 95% CI = 0.76–2.22, p = 0.339). The association between presence of diabetes complications and the occurrence of acute epiglottitis was also not significant among diabetic patients in this study setting (aOR = 0.86, 95% CI = 0.59–1.26, p = 0.439).ConclusionsThe results of our large-scale population-based case–control study indicate that preexisting DM is one of the possible factors associated with the development of acute epiglottitis. Physicians should pay attention to the symptoms and signs of acute epiglottitis in DM patients, particularly in men aged 35–64 years.

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Risk of pneumonia in patients with gastroesophageal reflux disease: A population-based cohort study

Cited by 44 publications

References 21 publications

Comparative effects of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on the risk of pneumonia and severe exacerbations in patients with COPD

Comparative effects of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on the risk of pneumonia and severe exacerbations in patients with COPD

The Prevalence of Anticholinergic Drugs and Correlation with Pneumonia in Elderly Patients: A Population-Based Study in Taiwan

Risk of acute epiglottitis in patients with preexisting diabetes mellitus: A population-based case–control study

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