Risk of pneumonia in adults with closed versus unclosed atrial septal defect (from a nationwide cohort study)
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Risk of pneumonia in adults with closed versus unclosed atrial septal defect (from a nationwide cohort study). / Nyboe, Camilla; Olsen, Morten S; Nielsen-Kudsk, Jens Erik; Johnsen, Søren P; Hjortdal, Vibeke E.
In: The American Journal of Cardiology, Vol. 114, No. 1, 01.07.2014, p. 105-10.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Risk of pneumonia in adults with closed versus unclosed atrial septal defect (from a nationwide cohort study)
AU - Nyboe, Camilla
AU - Olsen, Morten S
AU - Nielsen-Kudsk, Jens Erik
AU - Johnsen, Søren P
AU - Hjortdal, Vibeke E
N1 - Copyright © 2014 Elsevier Inc. All rights reserved.
PY - 2014/7/1
Y1 - 2014/7/1
N2 - Atrial septal defect (ASD) is associated with pulmonary hyperperfusion and inflammation and has been linked with increased risk of pneumonia. We investigated the risk of pneumonia in patients with ASD and the impact of ASD closure in a nationwide cohort study. All adults in Denmark (n = 1,168) diagnosed with ASD from 1977 to 2009 were identified through Danish public registries. We compared the risk of hospitalization for pneumonia, use of antibiotics, and mortality with age- and gender-matched general population controls. The median follow-up from time of diagnosis was 9.6 years (range 1 to 33). Cox regression analysis showed that both patients with closed (n = 863) and unclosed (n = 305) ASD had a higher risk of hospitalization for pneumonia (adjusted hazard ratios [HRs] 2.8, 95% confidence interval [CI] 2.3 to 3.5 and 3.1, 95% CI 2.4 to 4.0, respectively) than controls. Patients with ASD also used more antibiotics (adjusted HR for closure 1.4, 95% CI 1.3 to 1.5 and adjusted HR for no closure 1.4, 95% CI 1.2 to 1.6) than the controls. Antibiotic use normalized (adjusted HR 1.1, 95% CI 1.0 to 1.3) and the risk of pneumonia decreased (adjusted HR 1.8, 95% CI 1.1 to 3.0) within 5 years after closure. The proportion of patients with ASD with pneumonia-related death (8.4%) was comparable with that of the general population (9.5%). In conclusion, patients with ASD had a substantially higher risk of hospitalization for pneumonia and used more antibiotics than the general population. The pneumonia risk diminished, but did not completely normalize, 5 years after closure.
AB - Atrial septal defect (ASD) is associated with pulmonary hyperperfusion and inflammation and has been linked with increased risk of pneumonia. We investigated the risk of pneumonia in patients with ASD and the impact of ASD closure in a nationwide cohort study. All adults in Denmark (n = 1,168) diagnosed with ASD from 1977 to 2009 were identified through Danish public registries. We compared the risk of hospitalization for pneumonia, use of antibiotics, and mortality with age- and gender-matched general population controls. The median follow-up from time of diagnosis was 9.6 years (range 1 to 33). Cox regression analysis showed that both patients with closed (n = 863) and unclosed (n = 305) ASD had a higher risk of hospitalization for pneumonia (adjusted hazard ratios [HRs] 2.8, 95% confidence interval [CI] 2.3 to 3.5 and 3.1, 95% CI 2.4 to 4.0, respectively) than controls. Patients with ASD also used more antibiotics (adjusted HR for closure 1.4, 95% CI 1.3 to 1.5 and adjusted HR for no closure 1.4, 95% CI 1.2 to 1.6) than the controls. Antibiotic use normalized (adjusted HR 1.1, 95% CI 1.0 to 1.3) and the risk of pneumonia decreased (adjusted HR 1.8, 95% CI 1.1 to 3.0) within 5 years after closure. The proportion of patients with ASD with pneumonia-related death (8.4%) was comparable with that of the general population (9.5%). In conclusion, patients with ASD had a substantially higher risk of hospitalization for pneumonia and used more antibiotics than the general population. The pneumonia risk diminished, but did not completely normalize, 5 years after closure.
KW - Adult
KW - Denmark/epidemiology
KW - Female
KW - Heart Septal Defects, Atrial/epidemiology
KW - Humans
KW - Incidence
KW - Male
KW - Patient Admission/statistics & numerical data
KW - Pneumonia/epidemiology
KW - Registries
KW - Risk
KW - Treatment Outcome
U2 - 10.1016/j.amjcard.2014.03.063
DO - 10.1016/j.amjcard.2014.03.063
M3 - Journal article
C2 - 24819903
VL - 114
SP - 105
EP - 110
JO - Am. J. Cardiol.
JF - Am. J. Cardiol.
SN - 0002-9149
IS - 1
ER -
ID: 242611464