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Risk of pneumonia among patients with chronic kidney disease in outpatient and inpatient settings: a nationwide population-based study.
Medicine (Baltimore). 2014 Dec; 93(27):e174.M

Abstract

Patients with chronic kidney disease (CKD) are more at risk for pneumonia than the general population. Patients with pneumonia are usually treated as outpatients. However, previous studies were conducted on the basis of inpatient pneumonia. This method may underestimate the risk of pneumonia in patients with CKD. Therefore, we investigated the risk of pneumonia among CKD patients in both outpatient and inpatient settings. A total of 15,562 patients with CKD and 62,109 individuals without CKD (matched for age and gender) were taken as subjects in the Longitudinal Health Insurance Database of Taiwan National Insurance from 1996 to 2010. The incidence density rates of inpatient and outpatient pneumonia were calculated. The risk factors associated with pneumonia were analyzed using Cox proportional hazard models with adjustments for confounders. The incidence density rate of pneumonia was 65.6 per 1000 person-years in patients with CKD and 28.4 per 1000 person-years in individuals without CKD. The incidence density rate of inpatient pneumonia was 43.3 per 1000 person-years in patients with CKD and 16.6 per 1000 person-years in individuals without CKD. CKD was associated with increased risk of pneumonia (adjusted hazard ratio [aHR], 1.97; 95% confidence interval [CI], 1.89-2.05; P < 0.001), outpatient pneumonia (aHR, 1.40; 95% CI, 1.31-1.49), and inpatient pneumonia (aHR, 2.17; 95% CI, 2.07-2.29, P < 0.001). Patients' comorbidities, including diabetes, cardiovascular disease (CVD), asthma, and chronic obstructive pulmonary disease (COPD), were independently associated with increased risk of pneumonia.CKD is associated with the increased risk of both outpatient and inpatient pneumonia. This association is independent of comorbid diabetes, CVD, asthma, and COPD.

Authors+Show Affiliations

From the Division of Nephrology and Kidney Institute (C-YC, S-MW, C-CL, C-TC, J-HL, I-KW, C-CH), Department of Internal Medicine; College of Medicine (C-YC, S-MW, C-CL, C-TC, J-HL, I-KW, L-CH, C-HM, C-CH); Division of Cardiology (L-CH), Department of Internal Medicine; Management Office for Health Data (C-HM), and Department of Public Health (R-YW), China Medical University and Hospital, Taichung, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25501062

Citation

Chou, Che-Yi, et al. "Risk of Pneumonia Among Patients With Chronic Kidney Disease in Outpatient and Inpatient Settings: a Nationwide Population-based Study." Medicine, vol. 93, no. 27, 2014, pp. e174.
Chou CY, Wang SM, Liang CC, et al. Risk of pneumonia among patients with chronic kidney disease in outpatient and inpatient settings: a nationwide population-based study. Medicine (Baltimore). 2014;93(27):e174.
Chou, C. Y., Wang, S. M., Liang, C. C., Chang, C. T., Liu, J. H., Wang, I. K., Hsiao, L. C., Muo, C. H., Huang, C. C., & Wang, R. Y. (2014). Risk of pneumonia among patients with chronic kidney disease in outpatient and inpatient settings: a nationwide population-based study. Medicine, 93(27), e174. https://doi.org/10.1097/MD.0000000000000174
Chou CY, et al. Risk of Pneumonia Among Patients With Chronic Kidney Disease in Outpatient and Inpatient Settings: a Nationwide Population-based Study. Medicine (Baltimore). 2014;93(27):e174. PubMed PMID: 25501062.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of pneumonia among patients with chronic kidney disease in outpatient and inpatient settings: a nationwide population-based study. AU - Chou,Che-Yi, AU - Wang,Shu-Ming, AU - Liang,Chih-Chia, AU - Chang,Chiz-Tzung, AU - Liu,Jiung-Hsiun, AU - Wang,I-Kuan, AU - Hsiao,Lien-Cheng, AU - Muo,Chih-Hsin, AU - Huang,Chiu-Ching, AU - Wang,Ruey-Yun, PY - 2014/12/16/entrez PY - 2014/12/17/pubmed PY - 2015/2/24/medline SP - e174 EP - e174 JF - Medicine JO - Medicine (Baltimore) VL - 93 IS - 27 N2 - Patients with chronic kidney disease (CKD) are more at risk for pneumonia than the general population. Patients with pneumonia are usually treated as outpatients. However, previous studies were conducted on the basis of inpatient pneumonia. This method may underestimate the risk of pneumonia in patients with CKD. Therefore, we investigated the risk of pneumonia among CKD patients in both outpatient and inpatient settings. A total of 15,562 patients with CKD and 62,109 individuals without CKD (matched for age and gender) were taken as subjects in the Longitudinal Health Insurance Database of Taiwan National Insurance from 1996 to 2010. The incidence density rates of inpatient and outpatient pneumonia were calculated. The risk factors associated with pneumonia were analyzed using Cox proportional hazard models with adjustments for confounders. The incidence density rate of pneumonia was 65.6 per 1000 person-years in patients with CKD and 28.4 per 1000 person-years in individuals without CKD. The incidence density rate of inpatient pneumonia was 43.3 per 1000 person-years in patients with CKD and 16.6 per 1000 person-years in individuals without CKD. CKD was associated with increased risk of pneumonia (adjusted hazard ratio [aHR], 1.97; 95% confidence interval [CI], 1.89-2.05; P < 0.001), outpatient pneumonia (aHR, 1.40; 95% CI, 1.31-1.49), and inpatient pneumonia (aHR, 2.17; 95% CI, 2.07-2.29, P < 0.001). Patients' comorbidities, including diabetes, cardiovascular disease (CVD), asthma, and chronic obstructive pulmonary disease (COPD), were independently associated with increased risk of pneumonia.CKD is associated with the increased risk of both outpatient and inpatient pneumonia. This association is independent of comorbid diabetes, CVD, asthma, and COPD. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/25501062/Risk_of_pneumonia_among_patients_with_chronic_kidney_disease_in_outpatient_and_inpatient_settings:_a_nationwide_population_based_study_ L2 - http://dx.doi.org/10.1097/MD.0000000000000174 DB - PRIME DP - Unbound Medicine ER -