Background: We previously reported an increased incidence of all-cause and pneumococcal pneumonia in adults with asthma. We hypothesized that adults with asthma might also suffer excess exacerbations of their pre-existing asthma following a pneumonia event.
Methods: We employed a retrospective matched-cohort design using US healthcare claims data. In each month of accrual (01/2010 thru 06/2013), adults 18-49 years of age with a pre-existing diagnosis of only asthma who developed pneumonia in that month (pneumonia patients) were matched (1:1, without replacement, on demographic and clinical profiles) to patients with only asthma who did not develop pneumonia in that month or during the next 30 days (comparison patients). All patients were required to be pneumonia free during the 1-year look-back period. Exacerbations of asthma were ascertained beginning 30 days after the pneumonia and ending 1 year later, and were identified based on hospitalization or emergency room visit with a diagnosis of asthma.
Results: Adults 18-49 years of age with asthma as their only comorbidity experienced a 5-fold increase in asthma-related hospitalizations and a 2-fold increase in asthma-related emergency room visits subsequent to hospitalization for all-cause pneumonia (figure) compared with asthmatic young adults who were not hospitalized for pneumonia. Similarly, asthmatic young adults experienced a 3-fold increase in hospitalization and a 1.5-fold increase in emergency room visits following an outpatient pneumonia event.
Conclusion: These findings suggest a prolonged impact of pneumonia in otherwise healthy young adults who have asthma, adding to the already recognized increased incidence of pneumonia in this population. Pneumonia prevention should be a high priority in young adults with asthma.
R. Sato, Pfizer Inc.: Employee , Salary
S. I. Pelton, Pfizer Inc.: Consultant , Grant Investigator and Scientific Advisor , Consulting fee , Research grant and Speaker honorarium
GSK Bio: Scientific Advisor , Consulting fee
D. Weycker, Pfizer Inc.: Research Contractor , Research support
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