Shanghai cohort of 32,236 adults: COPD tied to odds ratio 2.08 for infection-related hospitalisation
In a population-based cohort in suburban Shanghai, COPD was associated with more infection-related hospitalisations, including non-respiratory infections, not only respiratory ones.
A population-based cohort study of adults aged 40 years and older in suburban Shanghai examined infections and infection-related hospitalisation in chronic obstructive pulmonary disease (COPD). The results were published in BMC Pulmonary Medicine. The cohort included 32,236 participants followed for 250,397 person-years, and 4,277 of them (13.3%) had COPD biomedcentral.com
BMC Pulmonary Medicinebiomedcentral.comOpen source ↗.
Infections are a major contributor to illness and hospitalisation in COPD. According to the authors, population-based evidence on infection-related hospitalisation, particularly beyond respiratory infections, has been limited.
Study design and methods
COPD was ascertained from electronic medical records and baseline surveys. Infection events were identified in an integrated healthcare information system using ICD-10 codes. Incidence densities were calculated per 1,000 person-years.
Total infections were analysed with negative binomial regression. For infection-related hospitalisations the authors used negative binomial hurdle models, which account for overdispersion and an excess of zeros.
Infection and hospitalisation results
After multivariable adjustment, COPD was associated with a higher incidence density of total infections (IRR = 1.76, 95% CI: 1.71–1.82) biomedcentral.com
BMC Pulmonary Medicinebiomedcentral.comOpen source ↗.
COPD was also associated with increased odds of infection-related hospitalisation (OR = 2.08, 95% CI: 1.87–2.31). For respiratory infections the odds ratio was 2.68 (95% CI: 2.36–3.05). For non-respiratory infections it was 1.43 (95% CI: 1.22–1.66), so the association was weaker but present.
Among participants with at least one infection-related hospitalisation, COPD was associated with a higher hospitalisation frequency for overall infection (IRR = 1.69, 95% CI: 1.37–2.09). For respiratory infection the ratio was 2.10 (95% CI: 1.60–2.74).
The authors concluded that COPD is associated with an increased risk of infection-related hospitalisation in a community-based cohort, and that the association extends beyond respiratory infections. They stated that infection prevention should be integrated into comprehensive COPD management. The study is observational and reports associations.
