title: Treatment for Multiple Acute Cardiopulmonary Conditions in Older Adults Hospitalized with Pneumonia, Chronic Obstructive Pulmonary Disease, or Heart Failure.
abstract: To determine how often hospitalized older adults principally diagnosed with pneumonia, chronic obstructive pulmonary disease (COPD), or heart failure (HF) are concurrently treated for two or more of these acute cardiopulmonary conditions.
  
  
  
  Retrospective cohort study.
  
  
  
  368 U.S. hospitals in the Premier research database.
  
  
  
  Individuals aged 65 and older principally hospitalized with pneumonia, COPD, or HF in 2009 or 2010.
  
  
  
  Proportion of diagnosed episodes of pneumonia, COPD, or HF concurrently treated for two or more of these acute cardiopulmonary conditions during the first 2 hospital days.
  
  
  
  Of 91,709 diagnosed pneumonia hospitalizations, 32% received treatment for two or more acute cardiopulmonary conditions (18% for HF, 18% for COPD, 4% for both). Of 41,052 diagnosed COPD hospitalizations, 19% received treatment for two or more acute cardiopulmonary conditions (all of which involved additional HF treatment). Of 118,061 diagnosed HF hospitalizations, 38% received treatment for two or more acute cardiopulmonary conditions (34% for pneumonia, 9% for COPD, 5% for both).
  
  
  
  Hospitalized older adults diagnosed with pneumonia, COPD, or HF are frequently treated for two or more acute cardiopulmonary conditions, suggesting that clinical syndromes often fall between traditional diagnostic categories. Research is needed to evaluate the risks and benefits of real-world treatment for the many older adults whose presentations elicit diagnostic uncertainty or concern about coexisting acute conditions.
authors.affiliation: Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.|Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.
authors.forename: Kumar
authors.initials: K
authors.lastname: Dharmarajan
authors.affiliation: Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Strait
authors.affiliation: Section of Geriatrics, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.|Section of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Tinetti
authors.affiliation: Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts.|Division of General Internal Medicine, Baystate Medical Center, Springfield, Massachusetts.|Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Tara
authors.initials: T
authors.lastname: Lagu
authors.affiliation: Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts.|Division of General Internal Medicine, Baystate Medical Center, Springfield, Massachusetts.|Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Peter K
authors.initials: PK
authors.lastname: Lindenauer
authors.affiliation: Altarum Institute, Washington, District of Columbia.
authors.forename: Joanne
authors.initials: J
authors.lastname: Lynn
authors.affiliation: Premier Research Services, Premier, Inc., Charlotte, North Carolina.
authors.forename: Michelle R
authors.initials: MR
authors.lastname: Krukas
authors.affiliation: Premier Research Services, Premier, Inc., Charlotte, North Carolina.
authors.forename: Frank R
authors.initials: FR
authors.lastname: Ernst
authors.affiliation: Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.
authors.forename: Shu-Xia
authors.initials: SX
authors.lastname: Li
authors.affiliation: Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.|Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.|Section of Health Policy and Administration, Yale University School of Public Health, New Haven, Connecticut.|Robert Wood Johnson Clinical Scholars Program, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Harlan M
authors.initials: HM
authors.lastname: Krumholz
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004232:Diuretics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000188:drug therapy* / Q000453:epidemiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000453:epidemiology*; D012189:Retrospective Studies; D014481:United States; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D002316:Cardiotonic Agents; D004232:Diuretics; D014665:Vasodilator Agents
keywords: cardiovascular disease; comorbidity; hospital medicine; pharmacoepidemiology; pulmonary diseases