ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.
Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.
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Pneumonia Burden and Exacerbations: A Large Real-World Evaluation of Events and Risks Among Chronic Obstructive Pulmonary Disease (COPD) Patients in the United States
Session Title
TP13 - TP013 DEMOGRAPHIC, PSYCHOSOCIAL, AND CLINICAL CORRELATES OF PULMONARY, CRITICAL CARE, AND LUNG DISEASES
Abstract
A1573 - Pneumonia Burden and Exacerbations: A Large Real-World Evaluation of Events and Risks Among Chronic Obstructive Pulmonary Disease (COPD) Patients in the United States
Author Block: A. D. Xi1, C. Moretz1, S. Kumar1, S. Sethi2, M. Pollack3, B. J. Make4, S. Robinson1, N. Feigler3, D. Powell1, J. Dreyfus1; 1Avalere Health, Washington, DC, United States, 2University of Buffalo, Buffalo, NY, United States, 3AstraZeneca, Wilmington, DE, United States, 4National Jewish Health, Denver, CO, United States.
Rationale: Pneumonia is an infection that occurs most frequently in older adults with multiple comorbidities, including chronic obstructive pulmonary disease (COPD). COPD-related exacerbations and pneumonia events can occur concurrently further complicating treatment approaches and extending recovery time. However, little is known about this relationship in the real world. The objective of this study was to describe these events in patients diagnosed with COPD. Methods: This retrospective study utilized Medicare Fee-for-Service (FFS) claims, and claims from multiple U.S. commercial (COM), Managed Medicaid (MM), and Medicare Advantage (MA) sources using the Inovalon MORE2 Registry®. Patients were aged ≥40 years with continuous enrollment 12-months pre- and post-index. Index date was first hospitalization, emergency department (ED) encounter, or first of two outpatient encounters (≥30 days apart) between 1/1/2016 -12/31/2017 with a COPD diagnosis (chronic bronchitis, emphysema, or chronic airway obstruction on the claim). Patient characteristics were examined during 12-month baseline period; pneumonia and exacerbation events were examined during 12-month post-index period. Pneumonia events were based upon the presence of diagnoses on a medical claim. Analyses were descriptive and unadjusted; statistical significance at p<0.05. Results: A total of 3,154,745 patients met selection criteria; 678,008 (21.5%) had ≥1 pneumonia events post-index. Mean age was higher among patients with pneumonia (73.3 vs. 71.3; p<0.05) as was mean Charlson Comorbidity score (4.2 vs. 3.4; p<0.05); 57.7% of pneumonia patients were female vs. 58.2% without pneumonia (p<0.05). Among those with pneumonia, 69.7% had 1 pneumonia event, 20.2% had 2 events, and 10.1% had ≥3 events. Among patients with pneumonia, 51.4% experienced a severe event involving an inpatient pneumonia diagnosis. During both the baseline and post-index periods, a greater proportion of patients with pneumonia had exacerbation events compared to those without pneumonia; post-index, 50.8% of pneumonia patients had an exacerbation compared to 30.7% of non-pneumonia patients (unadjusted OR 2.33, 95%CI 2.31-2.34). Among patients with pneumonia, 19.4% had a severe COPD exacerbation requiring hospitalization compared to 3.7% without pneumonia (unadjusted OR 6.28, 95%CI 6.22-6.34). Overall, 21.3% of pneumonia patients had post-index COPD exacerbations overlapping with a pneumonia episode. (Table) Conclusion: Among patients who had been hospitalized with a COPD diagnosis and were subsequently diagnosed with pneumonia COPD exacerbations were more common than in those who did not have a pneumonia event. Treatment options that present a favorable clinical profile to minimize risk of both pneumonia and exacerbations should be considered for these patients.
Author Block: A. D. Xi1, C. Moretz1, S. Kumar1, S. Sethi2, M. Pollack3, B. J. Make4, S. Robinson1, N. Feigler3, D. Powell1, J. Dreyfus1; 1Avalere Health, Washington, DC, United States, 2University of Buffalo, Buffalo, NY, United States, 3AstraZeneca, Wilmington, DE, United States, 4National Jewish Health, Denver, CO, United States.
Rationale: Pneumonia is an infection that occurs most frequently in older adults with multiple comorbidities, including chronic obstructive pulmonary disease (COPD). COPD-related exacerbations and pneumonia events can occur concurrently further complicating treatment approaches and extending recovery time. However, little is known about this relationship in the real world. The objective of this study was to describe these events in patients diagnosed with COPD. Methods: This retrospective study utilized Medicare Fee-for-Service (FFS) claims, and claims from multiple U.S. commercial (COM), Managed Medicaid (MM), and Medicare Advantage (MA) sources using the Inovalon MORE2 Registry®. Patients were aged ≥40 years with continuous enrollment 12-months pre- and post-index. Index date was first hospitalization, emergency department (ED) encounter, or first of two outpatient encounters (≥30 days apart) between 1/1/2016 -12/31/2017 with a COPD diagnosis (chronic bronchitis, emphysema, or chronic airway obstruction on the claim). Patient characteristics were examined during 12-month baseline period; pneumonia and exacerbation events were examined during 12-month post-index period. Pneumonia events were based upon the presence of diagnoses on a medical claim. Analyses were descriptive and unadjusted; statistical significance at p<0.05. Results: A total of 3,154,745 patients met selection criteria; 678,008 (21.5%) had ≥1 pneumonia events post-index. Mean age was higher among patients with pneumonia (73.3 vs. 71.3; p<0.05) as was mean Charlson Comorbidity score (4.2 vs. 3.4; p<0.05); 57.7% of pneumonia patients were female vs. 58.2% without pneumonia (p<0.05). Among those with pneumonia, 69.7% had 1 pneumonia event, 20.2% had 2 events, and 10.1% had ≥3 events. Among patients with pneumonia, 51.4% experienced a severe event involving an inpatient pneumonia diagnosis. During both the baseline and post-index periods, a greater proportion of patients with pneumonia had exacerbation events compared to those without pneumonia; post-index, 50.8% of pneumonia patients had an exacerbation compared to 30.7% of non-pneumonia patients (unadjusted OR 2.33, 95%CI 2.31-2.34). Among patients with pneumonia, 19.4% had a severe COPD exacerbation requiring hospitalization compared to 3.7% without pneumonia (unadjusted OR 6.28, 95%CI 6.22-6.34). Overall, 21.3% of pneumonia patients had post-index COPD exacerbations overlapping with a pneumonia episode. (Table) Conclusion: Among patients who had been hospitalized with a COPD diagnosis and were subsequently diagnosed with pneumonia COPD exacerbations were more common than in those who did not have a pneumonia event. Treatment options that present a favorable clinical profile to minimize risk of both pneumonia and exacerbations should be considered for these patients.
