Open AccessAssociations between Community‐Acquired Pneumonia and Proton Pump Inhibitors in the Laryngeal/Voice‐Disordered Population
Author(s) -
Cohen Seth M.,
Lee HuiJie,
Leiman David A.,
Roy Nelson,
Misono Stephanie
Publication year - 2019
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599818811292
Subject(s) - medicine , community acquired pneumonia , medical prescription , retrospective cohort study , proton pump inhibitor , cohort , medical diagnosis , diagnosis code , population , pneumonia , pediatrics , pathology , environmental health , pharmacology
Objectives To examine the relationship between community‐acquired pneumonia (CAP) and proton pump inhibitor (PPI) treatment among patients with laryngeal/voice disorders. Study Design Retrospective cohort analysis. Setting Large national administrative US claims database. Subjects and Methods Patients were included if they were ≥18 years old; had outpatient treatment for a laryngeal/voice disorder from January 1, 2010, to December 31, 2014 (per International Classification of Diseases, Ninth Revision, Clinical Modification codes); had 12 months of continuous enrollment prior to the index date (ie, first diagnosis of laryngeal/voice disorder); had no preindex diagnosis of CAP; and had prescription claims captured from 1 year preindex to end of follow‐up. Patient demographics, comorbid conditions, index laryngeal diagnosis, number of unique preindex patient encounters, and CAP diagnoses during the postindex 3 years were collected. Two models—a time‐dependent Cox regression model and a propensity score–based approach with a marginal structural model—were separately performed for patients with and without pre–index date PPI prescriptions. Results A total of 392,355 unique patients met inclusion criteria; 188,128 (47.9%) had a PPI prescription. The 3‐year absolute risk for CAP was 4.0% and 5.3% among patients without and with preindex PPI use, respectively. For patients without and with pre–index date PPI use, the CAP occurrence for a person who had already received a PPI is 30% to 50% higher, respectively, than for a person who had not yet had a PPI but may receive one later. Conclusions Patients without and with pre–index date PPI use experienced a roughly 30% to 50% increased likelihood of CAP, respectively, as compared with patients who had not had PPI prescriptions.