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COPD is associated with increased mortality in patients with community-acquired pneumonia

¹ The Veterans Evidence-based Research, Dissemination, and Implementation Center, Audie L Murphy Veterans Hospital, and, Divisions of ² General Medicine, and ³ Pulmonary and Critical Care Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.

CORRESPONDENCE: M. I. Restrepo, VERDICT (11C6) at the South Texas Veterans Health Care System, Audie L. Murphy Division at San Antonio, 7400 Merton Minter Boulevard, San Antonio TX, 78284, USA. Fax: 1 2105674423. E-mail: restrepom{at}uthscsa.edu

Keywords: Chronic obstructive pulmonary disease, community-acquired pneumonia, mortality

Received: November 10, 2005
Accepted April 7, 2006

Patients with chronic obstructive pulmonary disease (COPD) who develop community-acquired pneumonia (CAP) may experience worse clinical outcomes. However, COPD is not included as a distinct diagnosis in validated instruments that predict mortality in patients with CAP. The aim of the present study was to evaluate the impact of COPD as a comorbid condition on 30- and 90-day mortality in CAP patients. A retrospective observational study was conducted at two hospitals. Eligible patients had a discharge diagnosis and radiological confirmation of CAP.

Among 744 patients with CAP, 215 had a comorbid diagnosis of COPD and 529 did not have COPD. The COPD group had a higher mean pneumonia severity index score (105±32 versus 87±34) and were admitted to the intensive care unit more frequently (25 versus 18%). After adjusting for severity of disease and processes of care, CAP patients with COPD showed significantly higher 30- and 90-day mortality than non-COPD patients.

Chronic obstructive pulmonary disease patients hospitalised with community-acquired pneumonia exhibited higher 30- and 90-day mortality than patients without chronic obstructive pulmonary disease. Chronic obstructive pulmonary disease should be evaluated for inclusion in community-acquired pneumonia prediction instruments.

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