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Pseudomonas aeruginosa and risk of death and exacerbations in patients with chronic obstructive pulmonary disease: an observational cohort study of 22.053 patients

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Eklöf, J, Sørensen, R, Ingebrigtsen, TS, Sivapalan, P, Achir, I, Boel, JB, Bangsborg, J, Ostergaard, C, Dessau, RB, Jensen, US, Browatzki, A, Lapperre, TS, Janner, J, Weinreich, UM, Armbruster, K, Wilcke, T, Seersholm, N & Jensen, JUS 2020, 'Pseudomonas aeruginosa and risk of death and exacerbations in patients with chronic obstructive pulmonary disease: an observational cohort study of 22.053 patients' Clinical Microbiology and Infection, vol. 26, no. 2, pp. 227-234. https://doi.org/10.1016/j.cmi.2019.06.011

APA

CBE

Eklöf J, Sørensen R, Ingebrigtsen TS, Sivapalan P, Achir I, Boel JB, Bangsborg J, Ostergaard C, Dessau RB, Jensen US, Browatzki A, Lapperre TS, Janner J, Weinreich UM, Armbruster K, Wilcke T, Seersholm N, Jensen JUS. 2020. Pseudomonas aeruginosa and risk of death and exacerbations in patients with chronic obstructive pulmonary disease: an observational cohort study of 22.053 patients. Clinical Microbiology and Infection. 26(2):227-234. https://doi.org/10.1016/j.cmi.2019.06.011

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Author

Eklöf, J ; Sørensen, R ; Ingebrigtsen, T S ; Sivapalan, P ; Achir, I ; Boel, J B ; Bangsborg, J ; Ostergaard, C ; Dessau, R B ; Jensen, U S ; Browatzki, A ; Lapperre, T S ; Janner, J ; Weinreich, U M ; Armbruster, K ; Wilcke, T ; Seersholm, N ; Jensen, J U S. / Pseudomonas aeruginosa and risk of death and exacerbations in patients with chronic obstructive pulmonary disease : an observational cohort study of 22.053 patients. In: Clinical Microbiology and Infection. 2020 ; Vol. 26, No. 2. pp. 227-234.

Bibtex

@article{6df7e39ccf4a4dcd881dd7841fa95dc4,
title = "Pseudomonas aeruginosa and risk of death and exacerbations in patients with chronic obstructive pulmonary disease: an observational cohort study of 22.053 patients",
abstract = "OBJECTIVES: The role of Pseudomonas aeruginosa in the long-term prognosis of chronic obstructive pulmonary disease (COPD) is unknown. The purpose of this study was to determine whether P. aeruginosa is associated with increased risk of exacerbations or death in patients with COPD.METHODS: This is a multiregional epidemiological study based on complete data on COPD outpatients between 1 January 2010 and 31 October 2017 and corresponding microbiology and national register data. Time-dependent Cox proportional hazards models and propensity matching was used to estimate hospitalization-demanding exacerbations and death after 2 years, separately and in combination.RESULTS: A total of 22 053 COPD outpatients were followed for a median of 1082 days (interquartile-range: 427-1862). P. aeruginosa was present in 905 (4.1{\%}) patients. During 730 days of follow-up, P. aeruginosa strongly and independently predicted an increased risk of hospitalization for exacerbation or all-cause death (HR 2.8, 95{\%}CI 2.2-3.6; p <0.0001) and all-cause death (HR 2.7, 95{\%}CI 2.3-3.4; p <0.0001) in analyses adjusted for known and suspected confounders. The signal remained unchanged in unadjusted analyses as well as propensity-matched subgroup analyses. Among patients 'ever colonized' with P. aeruginosa, the incidence of hospital-demanding exacerbations doubled after the time of the first colonization.CONCLUSIONS: COPD patients in whom P. aeruginosa can be cultured from the airways had a markedly increased risk of exacerbations and death. It is still not clear whether this risk can be reduced by offering patients targeted antipseudomonal antibiotics. A randomized trial is currently recruiting patients to clarify this (ClinicalTrials.gov: NCT03262142).",
keywords = "Complete long-term follow-up, COPD, Lung infection, Multiregional epidemiological study, National patient registers, Pseudomonas aeruginosa",
author = "J Ekl{\"o}f and R S{\o}rensen and Ingebrigtsen, {T S} and P Sivapalan and I Achir and Boel, {J B} and J Bangsborg and C Ostergaard and Dessau, {R B} and Jensen, {U S} and A Browatzki and Lapperre, {T S} and J Janner and Weinreich, {U M} and K Armbruster and T Wilcke and N Seersholm and Jensen, {J U S}",
note = "Copyright {\circledC} 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.",
year = "2020",
doi = "10.1016/j.cmi.2019.06.011",
language = "English",
volume = "26",
pages = "227--234",
journal = "Clinical Microbiology and Infection",
issn = "1198-743X",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "2",

}

RIS

TY - JOUR

T1 - Pseudomonas aeruginosa and risk of death and exacerbations in patients with chronic obstructive pulmonary disease

T2 - an observational cohort study of 22.053 patients

AU - Eklöf, J

AU - Sørensen, R

AU - Ingebrigtsen, T S

AU - Sivapalan, P

AU - Achir, I

AU - Boel, J B

AU - Bangsborg, J

AU - Ostergaard, C

AU - Dessau, R B

AU - Jensen, U S

AU - Browatzki, A

AU - Lapperre, T S

AU - Janner, J

AU - Weinreich, U M

AU - Armbruster, K

AU - Wilcke, T

AU - Seersholm, N

AU - Jensen, J U S

N1 - Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.

PY - 2020

Y1 - 2020

N2 - OBJECTIVES: The role of Pseudomonas aeruginosa in the long-term prognosis of chronic obstructive pulmonary disease (COPD) is unknown. The purpose of this study was to determine whether P. aeruginosa is associated with increased risk of exacerbations or death in patients with COPD.METHODS: This is a multiregional epidemiological study based on complete data on COPD outpatients between 1 January 2010 and 31 October 2017 and corresponding microbiology and national register data. Time-dependent Cox proportional hazards models and propensity matching was used to estimate hospitalization-demanding exacerbations and death after 2 years, separately and in combination.RESULTS: A total of 22 053 COPD outpatients were followed for a median of 1082 days (interquartile-range: 427-1862). P. aeruginosa was present in 905 (4.1%) patients. During 730 days of follow-up, P. aeruginosa strongly and independently predicted an increased risk of hospitalization for exacerbation or all-cause death (HR 2.8, 95%CI 2.2-3.6; p <0.0001) and all-cause death (HR 2.7, 95%CI 2.3-3.4; p <0.0001) in analyses adjusted for known and suspected confounders. The signal remained unchanged in unadjusted analyses as well as propensity-matched subgroup analyses. Among patients 'ever colonized' with P. aeruginosa, the incidence of hospital-demanding exacerbations doubled after the time of the first colonization.CONCLUSIONS: COPD patients in whom P. aeruginosa can be cultured from the airways had a markedly increased risk of exacerbations and death. It is still not clear whether this risk can be reduced by offering patients targeted antipseudomonal antibiotics. A randomized trial is currently recruiting patients to clarify this (ClinicalTrials.gov: NCT03262142).

AB - OBJECTIVES: The role of Pseudomonas aeruginosa in the long-term prognosis of chronic obstructive pulmonary disease (COPD) is unknown. The purpose of this study was to determine whether P. aeruginosa is associated with increased risk of exacerbations or death in patients with COPD.METHODS: This is a multiregional epidemiological study based on complete data on COPD outpatients between 1 January 2010 and 31 October 2017 and corresponding microbiology and national register data. Time-dependent Cox proportional hazards models and propensity matching was used to estimate hospitalization-demanding exacerbations and death after 2 years, separately and in combination.RESULTS: A total of 22 053 COPD outpatients were followed for a median of 1082 days (interquartile-range: 427-1862). P. aeruginosa was present in 905 (4.1%) patients. During 730 days of follow-up, P. aeruginosa strongly and independently predicted an increased risk of hospitalization for exacerbation or all-cause death (HR 2.8, 95%CI 2.2-3.6; p <0.0001) and all-cause death (HR 2.7, 95%CI 2.3-3.4; p <0.0001) in analyses adjusted for known and suspected confounders. The signal remained unchanged in unadjusted analyses as well as propensity-matched subgroup analyses. Among patients 'ever colonized' with P. aeruginosa, the incidence of hospital-demanding exacerbations doubled after the time of the first colonization.CONCLUSIONS: COPD patients in whom P. aeruginosa can be cultured from the airways had a markedly increased risk of exacerbations and death. It is still not clear whether this risk can be reduced by offering patients targeted antipseudomonal antibiotics. A randomized trial is currently recruiting patients to clarify this (ClinicalTrials.gov: NCT03262142).

KW - Complete long-term follow-up

KW - COPD

KW - Lung infection

KW - Multiregional epidemiological study

KW - National patient registers

KW - Pseudomonas aeruginosa

UR - http://www.scopus.com/inward/record.url?scp=85069743047&partnerID=8YFLogxK

U2 - 10.1016/j.cmi.2019.06.011

DO - 10.1016/j.cmi.2019.06.011

M3 - Journal article

VL - 26

SP - 227

EP - 234

JO - Clinical Microbiology and Infection

JF - Clinical Microbiology and Infection

SN - 1198-743X

IS - 2

ER -

ID: 57456165