RT Journal Article
SR Electronic
T1 Severity and outcomes of hospitalised community-acquired pneumonia in COPD patients
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 855
OP 861
DO 10.1183/09031936.00067111
VO 39
IS 4
A1 A. Liapikou
A1 E. Polverino
A1 S. Ewig
A1 C. Cillóniz
A1 M.A. Marcos
A1 J. Mensa
A1 S. Bello
A1 I. Martin-Loeches
A1 R. Menéndez
A1 A. Torres
YR 2012
UL http://erj.ersjournals.com/content/39/4/855.abstract
AB Chronic obstructive pulmonary disease (COPD) is a frequent comorbidity in patients with community-acquired pneumonia (CAP). We investigated the impact of COPD on outcomes of CAP patients. We prospectively studied the clinical presentation of 1,379 patients admitted with CAP during a 4-yr period. A comparative analysis of disease severity and course was performed between 212 patients with COPD, as confirmed by spirometry, and 1,167 non-COPD patients. COPD patients (mean forced expiratory volume in 1 s 47.7±16.3% predicted) were older and more likely to have previously received antibiotics (37.1% versus 28.3%; p<0.01) than those without COPD. They presented with more severe respiratory failure (arterial oxygen tension/inspiratory oxygen fraction 270.4 versus 287.8; p<0.01) and more severe pneumonia (pneumonia severity index 118.3 versus 108.5; p<0.001) compared with non-COPD patients. However, COPD patients had less multilobar infiltration (44 (21%) versus 349 (30%); p<0.01) and fewer pulmonary complications (24 (14%) versus 241 (24%); p<0.01). A total of 89 (6.5%) patients died within 30 days. COPD patients had no significant difference in their 30-day mortality rate compared with non-COPD patients (nine (4.2%) patients versus 81 (7%); p=0.14). Despite worse clinical presentation, COPD patients had a similar mortality rate compared to non-COPD patients. Previous antibiotic treatment and the decreased incidence of pulmonary complications in COPD may account for these findings.