Chronic pulmonary diseases and the epidemiology of invasive pneumococcal infection
2012
Chronic pulmonary disease is an established risk factors for acquiring invasive pneumococcal disease (IPD), but estimates have in most cases been based on studies with aggregated denominator data on co-morbidities and have not been large enough to allow detailed analyses on less prevalent pulmonary diseases. There have also been conflicting results whether or not an underlying pulmonary disease increases the risk of death from IPD.
We examined the association between COPD, asthma, pulmonary fibrosis, sarcoidosis and pneumoconiosis and IPD, and the impact of these diseases on mortality from IPD.
IPD cases ≥18 years of age, 1990-2007, were identified via computerized databases. The associations between IPD and prior pulmonary diseases were assessed using conditional logistic regression, comparing IPD cases to 10 control subjects randomly selected from the general population (matched for sex, year of birth and county of residence). Adjustments were made for other chronic diseases, educational level and socio-economic position. Information on these was obtained through record linkage with other national databases.
4,085 cases of IPD were identified. COPD was associated with increased risk of IPD, (adjusted OR [aOR]: 4.7 (95% CI 4.0-5.6), as well as asthma (aOR: 2.2 [95% CI: 1.6-2.8]) and pulmonary fibrosis (aOR: 5.3 [95% CI:2 .8-10.0), whereas sarcoidosis and pneumoconiosis were not independently associated with increased risk of IPD. In-hospital mortality and 28-days mortality was not increased for patients suffering from the pulmonary diseases studied.
Several but not all pulmonary diseases increase the risk of IPD although this seems not be a risk factor for increased case-fatality rate.
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