1 research outputs found
Neumon铆as adquiridas en la comunidad en pacientes con enfermedad pulmonar obstructiva cr贸nica tratados con corticoides inhalados u otros broncodilatadores. Estudio PNEUMOCORT
OBJECTIVES: To analyse the risk of pneumonia and/or
exacerbations in patients with chronic obstructive pulmonary
disease (COPD) who receive treatment with inhaled
corticosteroids (CI), in comparison with those who are not
treated with inhaled corticosteroids (NCI). To estimate the risk
of pneumonia according to CI dose. DESIGN: Population-based
cohort study. SETTING: Primary Healthcare. Institut Catala de la
Salut. PARTICIPANTS: Patients >/=45 years-old diagnosed with
COPD between 2007 and 2009 in the Information System for
Research in Primary Care (SIDIAP). INTERVENTION: Two cohorts;
patients initiating CI and patients initiating bronchodilators
after COPD diagnosis. MAIN MEASUREMENTS: Demographics, smoking,
medical history, pneumonias, exacerbations, vaccinations, and
drug therapy. RESULTS: A total of 3,837 patients were included,
58% in the CI and 42% in the NCI group. Higher incidence rates
of pneumonia and exacerbations were detected in the CI group
compared with the NCI (2.18 vs. 1.37). The risk of pneumonia and
severe exacerbations was not significantly different between
groups, HR; 1.17 (95% CI; 0.87-1.56) and 1.06 (95% CI;
0.87-1.31), respectively. Patients in the CI group had a higher
risk of mild exacerbations, HR; 1.28 (95% CI; 1.10-1.50).
Variables associated with a higher risk of pneumonia were age,
diabetes, previous pneumonias and bronchitis, very severe COPD,
treatment with low doses of beta2-adrenergic or anticholinergic
agents, and previous treatment with oral corticosteroids.
CONCLUSIONS: There were no differences between cohorts in the
risk of pneumonia and severe exacerbations. The risk of mild
exacerbations was higher in the CI group. Pneumonias and severe
exacerbations were more frequent in patients with severe COPD
and in patients receiving high doses of CI