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Open AccessArticle

Risks of Pneumonia in COPD Patients with New-Onset Atrial Fibrillation

1
Medical Research Center, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei City 23141, Taiwan
2
Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying 73657, Taiwan
3
Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu-Jen Catholic University, No.362, Zhongzheng Road, Xindian District, New Taipei City 23148, Taiwan
4
Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei 10048, Taiwan
5
Institute of Population Health Sciences, National Health Research Institutes, Zhunan 35053, Taiwan
*
Authors to whom correspondence should be addressed.
Membership of the Taiwan Clinical Trial Consortium for Respiratory Diseases is provided in the Acknowledgments.
J. Clin. Med. 2018, 7(9), 229; https://doi.org/10.3390/jcm7090229
Received: 20 July 2018 / Revised: 8 August 2018 / Accepted: 16 August 2018 / Published: 21 August 2018
(This article belongs to the Section Pulmonology)
The association between Atrial Fibrillation (AF) and pneumonia remains unclear. This study aims to assess the impact of AF on high pneumonia risk group—chronic obstructive pulmonary disease (COPD)—In order to find the association between AF and the risk of pneumonia. The COPD cohort was extracted from National Health Research Institute of Taiwan. The AF cohort comprised all COPD patients with new-onset AF (International Classification of Diseases (ICD)-9 code 427.31) after COPD diagnosis. We further sampled non-AF cohort and performed 1:1 propensity score matched analysis to improve the balance of baseline characteristics between AF and non-AF cohort. The outcomes were pneumonia and pneumonia requiring mechanical ventilation (MV). From 2000–2011, a total of 6228 patients with COPD and AF, and matched 84,106 control subjects were enrolled. After propensity score matching, we identified 6219 patients, each with AF, and matched controls without AF. After propensity score matching, the AF cohorts had higher risk of mortality (adjusted hazard ratio (aHR), 1.24; 95% confidence interval (CI), 1.15–1.34), pneumonia (aHR, 1.17; 95% CI, 1.07–1.27), and pneumonia requiring MV (aHR, 1.33; 95% CI, 1.18–1.50) in comparison with the matched non-AF cohort. After adjusting for mortality from causes other than outcomes of interest as a competing risk, AF remains significantly associated with pneumonia and pneumonia requiring MV. The risks of pneumonia were higher in this population with AF than in those without AF, and the risk was still significant after the adjustment for the competing risk of all-cause mortality. View Full-Text
Keywords: atrial fibrillation; chronic obstructive pulmonary disease; pneumonia; risk atrial fibrillation; chronic obstructive pulmonary disease; pneumonia; risk
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MDPI and ACS Style

Wang, Y.-H.; Lai, C.-C.; Wang, C.-Y.; Wang, H.-C.; Yu, C.-J.; Chen, L.; On Behalf of the Taiwan Clinical Trial Consortium for Respiratory Diseases. Risks of Pneumonia in COPD Patients with New-Onset Atrial Fibrillation. J. Clin. Med. 2018, 7, 229.

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