PT  - JOURNAL ARTICLE
AU  - Frank Dusemund
AU  - Joannis Chronis
AU  - Florent Baty
AU  - Werner Albrich
AU  - Martin Brutsche
TI  - The outcome of community-acquired pneumonia in patients with COPD, asthma and ILD - a case-control study
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P2470
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P2470.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P2470.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - BackgroundThe impact of preexisting chronic lung diseases on complications and outcome in CAP is not well described. We aimed to investigate the impact of COPD, asthma and ILD on complications and outcome in hospitalized adult CAP-patients in a matched case-control study.MethodsWe used a nation-wide database including all hospitalizations in Switzerland from 2002 to 2010. Inclusion criteria were hospitalization due to CAP and age over 17 years. Exclusion criteria were HIV-infection, cancer and chronic lung diseases except COPD, asthma and ILD. The groups were matched according to age, gender and month of hospitalization. Endpoints were the incidence of lung abscess, parapneumonic pleural effusion, empyema, ARDS, in-hospital mortality and length of stay.ResultsWe found less disease-related complications of CAP in hospitalized COPD and asthma patients compared with their controls. This difference was in both groups mainly related to a lower incidence of pleural effusion (COPD: 4.3% vs. 4.9%, p=0.011; asthma: 3.4% vs. 5.2%, p<0.001). In-hospital mortality was also lower in the COPD and - much more pronounced - asthma cohorts (COPD: 5.8% vs. 6.7%, p<0.001; asthma: 1.4% vs. 4.8%, p<0.001). For ILD, complication rate was similar as compared to the control group, whereas in-hospital mortality was markedly higher (16.3% vs. 6.8%, p<0.001).ConclusionsOur novel and provocative results should be viewed as hypothesis-generating, with different possible explanations for our findings, including possible influence of ICS therapy, a possibly higher awareness of physicians while treating patients with chronic lung diseases, the different germ spectrum or an up-regulated immune response.