The log-rank test revealed a significant observed difference (< 0.001) over the entire Kaplan-Meier curve. PPIs and HR2As respectively. The risk of pneumonia existed when patients had used concurrent PPIs (adjusted hazard ratio [HR] = 1.76; 95% confidence interval [CI] = 1.33-2.34) or HR2As (adjusted HR = 1.25; 95% CI = 1.07-1.47). The positive association was lost in the cases over 70 years. The ratio of mortality also increased in those with PPIs SR 11302 or HR2As. Conclusion: Acid-suppressing drugs, especially PPIs, are attributed to more pneumonia happening in COPD patients compare with nonusers. The association was lost SR 11302 in elderly cases. Use acid-suppressing drugs should be careful about a higher possibility of pneumonia in more youthful individuals with COPD. < 0.05 was considered as statistically significant. Kaplan-Meier method was utilized for comparing the survival curves. All statistical analyses were performed using SPSS V.18.0 for Windows (SPSS, Inc, Chicago, Illinois, USA). RESULTS The following period was 10-12 months, and a total of 17,498 newly-diagnosed patients with COPD were included as the study cohort, of whom 109 (0.6%) and 526 (3%) cases had used PPIs and HR2As respectively. Table 1 lists the demographic characteristics, medical conditions, and medication use of each group of patients. Table 2 shows a ratio of pneumonia and mortality among the three groups. The distributions of geographical regions and histories of preexisting diseases were different, and the patients with concurrent prescriptions with acid-suppressing drugs, either PPIs or HR2As, owned older age, male predominant, more comorbidity, concurrent prescriptions of glucocorticoids, and a higher ratio of pneumonia or mortality. Table 1 The number of baseline characteristics in newly identified COPD patients in 2000-2005 Open in a separate window Table 2 The number and ratio of Rabbit polyclonal to PDGF C pneumonia and mortality in the COPD patients Open in a separate window The strength of the association between medical history of acid-suppressing drugs and pneumonia and mortality is usually disclosed in Furniture ?Furniture33 and ?and4.4. After adjustment for measured potential confounders, SR 11302 including age, sex, glucocorticoids and comorbidities, the risk of pneumonia existed when patients had used concurrent PPIs (adjusted HR = 1.76; 95% CI = 1.33-2.34) or HR2As (adjusted HR = 1.25; 95% CI = 1.07-1.47). The positive association was lost in the cases over 70 years (PPI adjusted HR = 1.25; 95% CI = 0.86-1.80, HR2As adjusted HR = 0.84; 95% CI = 0.68-1.05), and more obvious in the younger ones (PPI adjusted HR = 3.39; 95% CI = 2.17-5.31, HR2As adjusted HR = 2.45; 95% CI = 1.94-3.08). The ratio of mortality increased in those with PPIs (adjusted HR = 2.39; 95% CI = 1.92-2.97) or HR2As (adjusted HR = 3.09; 95% CI = 2.80-3.42), in both younger and elderly individuals. Table 3 HR and 95% CI of pneumonia associated with risk factors in multivariate Cox’s regression analysis Open in a separate window Table 4 HR and 95% CI of death associated with risk factors in multivariate Cox’s regression analysis Open in a separate window Physique 1 illustrates the results of the Kaplan-Meier method for the incidences of pneumonia in this cohort. Patients who take acid-suppressing drugs, especially PPI, owned a higher possibility of pneumonia than the nonusers. The longer the follow-up, the greater the differences were among the three groups. The ratio of pneumonia in the individuals who taking PPI, HR2As and nonuser was 45%, 30.6% and 18.5% respectively after a 10-year following period. The log-rank test revealed a significant observed difference (< 0.001) over the entire Kaplan-Meier curve. Figures ?Figures22 and ?and33 display the results of the Kaplan-Meier method for the CAP of cases over or below 70 years respectively, and the younger patients taking acid-suppressing drugs had an unfavorable outcome (< 0.001), but the difference disappeared in the elderly ones (= 0.111). Open in a separate window Physique 1 Kaplan-Meier method for the incidences of pneumonia in the cohort of newly identified chronic obstructive pulmonary disease patients in 2000-2005 Open in a separate window Physique 2 Kaplan-Meier method for the incidences of pneumonia in the younger.