학술논문
Incidence and clinical outcomes of pneumonia in persons with down syndrome in the United States.
Document Type
Academic Journal
Author
Janoff EN; Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA; Denver Veterans Affairs Medical Center, Aurora, CO, USA. Electronic address: Edward.Janoff@cuanschutz.edu.; Tseng HF; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.; Nguyen JL; Medical Development and Scientific/Clinical Affairs, Pfizer Vaccines, Collegeville, PA, USA.; Alfred T; Statistical Research and Data Science Center, Pfizer Inc, New York, NY, USA.; Vietri J; Patient and Health Impact, Pfizer Inc, Collegeville, PA, USA.; McDaniel A; Medical Development and Scientific/Clinical Affairs, Pfizer Vaccines, Collegeville, PA, USA.; Chilson E; Medical Development and Scientific/Clinical Affairs, Pfizer Vaccines, Collegeville, PA, USA.; Yan Q; Medical Development and Scientific/Clinical Affairs, Pfizer Vaccines, Collegeville, PA, USA.; Malhotra D; Patient and Health Impact, Pfizer Inc, New York, NY, USA.; Isturiz RE; Medical Development and Scientific/Clinical Affairs, Pfizer Vaccines, Collegeville, PA, USA.; Levin MJ; Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
Source
Publisher: Elsevier Science Country of Publication: Netherlands NLM ID: 8406899 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-2518 (Electronic) Linking ISSN: 0264410X NLM ISO Abbreviation: Vaccine Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Persons with Down syndrome (DS) experience an increased risk of pneumonia. We determined the incidence and outcomes of pneumonia and relationship to underlying comorbidities in persons with and without DS in the United States.
Methods: This retrospective matched cohort study used de-identified administrative claims data from Optum. Persons with DS were matched 1:4 to persons without DS on age, sex, and race/ethnicity. Pneumonia episodes were analyzed for incidence, rate ratios and 95 % confidence intervals, clinical outcomes, and comorbidities.
Results: During 1-year follow-up among 33796 persons with and 135184 without DS, the incidence of all-cause pneumonia (pneumonia) was substantially higher among people with DS than those without DS (12427 vs. 2531 episodes/100000 person-years; 4.7-5.7 fold increase). Persons with DS and pneumonia were more likely to be hospitalized (39.4 % vs. 13.9 %) or admitted to the ICU (16.8 % vs. 4.8 %). Mortality was higher 1 year after first pneumonia (5.7 % vs. 2.4 %; P < 0.0001). Results were similar for episodes of pneumococcal pneumonia. Specific comorbidities were associated with pneumonia, particularly heart disease in children and neurologic disease in adults, which only partially mediated the effect of DS on pneumonia.
Conclusions: Among persons with DS, incidence of pneumonia and associated hospitalizations were increased; mortality among those with pneumonia was comparable at 30 days, but higher at 1 year. DS should be considered an independent risk condition for pneumonia.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ENJ received support from the Linda Crnic Institute for Down Syndrome and NIH RO1:AI108479. JLN, TA, JV, AM, EC, QY, DM, and REI are employees of Pfizer Inc. and may hold stock or stock options.
(Copyright © 2023. Published by Elsevier Ltd.)
Methods: This retrospective matched cohort study used de-identified administrative claims data from Optum. Persons with DS were matched 1:4 to persons without DS on age, sex, and race/ethnicity. Pneumonia episodes were analyzed for incidence, rate ratios and 95 % confidence intervals, clinical outcomes, and comorbidities.
Results: During 1-year follow-up among 33796 persons with and 135184 without DS, the incidence of all-cause pneumonia (pneumonia) was substantially higher among people with DS than those without DS (12427 vs. 2531 episodes/100000 person-years; 4.7-5.7 fold increase). Persons with DS and pneumonia were more likely to be hospitalized (39.4 % vs. 13.9 %) or admitted to the ICU (16.8 % vs. 4.8 %). Mortality was higher 1 year after first pneumonia (5.7 % vs. 2.4 %; P < 0.0001). Results were similar for episodes of pneumococcal pneumonia. Specific comorbidities were associated with pneumonia, particularly heart disease in children and neurologic disease in adults, which only partially mediated the effect of DS on pneumonia.
Conclusions: Among persons with DS, incidence of pneumonia and associated hospitalizations were increased; mortality among those with pneumonia was comparable at 30 days, but higher at 1 year. DS should be considered an independent risk condition for pneumonia.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ENJ received support from the Linda Crnic Institute for Down Syndrome and NIH RO1:AI108479. JLN, TA, JV, AM, EC, QY, DM, and REI are employees of Pfizer Inc. and may hold stock or stock options.
(Copyright © 2023. Published by Elsevier Ltd.)