TY - JOUR T1 - Impact of inhaled corticosteroid use on outcome in COPD patients admitted with pneumonia JF - European Respiratory Journal JO - Eur Respir J SP - 36 LP - 41 DO - 10.1183/09031936.00077010 VL - 38 IS - 1 AU - A. Singanayagam AU - J.D. Chalmers AU - A.R. Akram AU - A.T. Hill Y1 - 2011/07/01 UR - http://erj.ersjournals.com/content/38/1/36.abstract N2 - The aim of this study was to investigate whether inhaled corticosteroid (ICS) use affects outcome in patients with chronic obstructive pulmonary disease (COPD) admitted with community-acquired pneumonia (CAP). This was a prospective, observational study of patients with spirometry-confirmed COPD presenting with a primary diagnosis of CAP in Lothian, UK. Outcome measures were compared between ICS users and non-ICS users. Of 490 patients included in the study, 76.7% were classified as ICS users. ICS users had higher Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage compared with non-ICS users (mean±sd 3.2±0.8 versus 2.6±0.9; p<0.0001). There were no significant differences in pneumonia severity (mean±sd Pneumonia Severity Index (PSI) 4.2±0.8 versus 4.3±0.8 (p = 0.3); mean±sd CURB-65 score 2.1±1.3 versus 2.3±1.3 (p = 0.07)) or markers of systemic inflammation (median C-reactive protein 148 (interquartile range 58–268) mg·L−1 versus 183 (IQR 85–302) mg·L−1; p = 0.08) between ICS users and non-ICS users. On multivariable analysis, after adjustment for COPD severity and PSI, ICS use was not independently associated with 30-day mortality (OR 1.71, 95% CI 0.75–3.90; p = 0.2), 6-month mortality (OR 1.62, 95% CI 0.82–3.16; p = 0.2), requirement for mechanical ventilation and/or inotropic support (OR 0.73, 95% CI 0.33–1.62; p = 0.4) or development of complicated pneumonia (OR 0.71, 95% CI 0.25–1.99; p = 0.5). Prior ICS use had no impact on outcome in patients with COPD admitted with CAP. ER -