Community-acquired pneumonia in patients with and without chronic obstructive pulmonary disease
Section snippets
Patients
From April 2003 to April 2004, a prospective multicenter observational study was carried out in seven hospitals in Asturias (Spain). The cohort comprised all patients admitted with community-acquired pneumonia. Exclusion criteria included patients admitted within the previous 15 days, and patients with severe immunosuppression, such as neutropenia (<500/mm3), human immunodeficiency virus (HIV) infection, solid organ or bone marrow transplants, treatment with steroids in doses >20 mg
Patient characteristics
We include 710 patients with CAP, mean age 67.14 (CI: 95%, 65.9–68.4). 244 had a concomitant clinical diagnosis of COPD, compared with 466 patients who did not have COPD. The main demographic characteristics, comorbidities, clinical data, and PSI index for each group as well as COPD severity and other features are shown in Table 1. COPD patients with CAP were significantly older, predominantly male, with higher PSI scores, alcohol drinkers, and ex-smokers. Diabetes and corticosteroid therapy
Discussion
In this study we compared CAP patients with and without COPD. Previous studies had no control group.5, 6, 7 In other studies,9 the definition of COPD was not based on pulmonary function tests, nor were they classified by degrees of severity.10 In our study, the CAP group with COPD had higher PSIs, explained by their older mean age, male predominance and some comorbidities like diabetes, hypoxemia and acidemia due to hypercapnia. Our results were similar to the other report.9
In our experience,
Conflict of interest
The authors have no conflict of interest to declare.
Acknowledgements
The authors acknowledge the comments and suggestions from A. Torres.
References (30)
- et al.
Community-acquired pneumonia as the initial manifestation of serious underlying diseases
Am J Med
(2005) - et al.
Evaluación pronóstica de las neumonías en pacientes con EPOC
Arch Bronconeumol
(2005) - et al.
Neumonía en el paciente con enfermedad pulmonar obstructiva crónica. Niveles de gravedad y clases de riesgo
Arch Bronconeumol
(2003) - et al.
Characteristics of community-acquired pneumonia in patients with chronic obstructive pulmonary disease
Respir Med
(2007) - et al.
Arterial carbon dioxide tension on admission as a marker of in-hospital mortality in community-acquired pneumonia
Am J Med
(2005) - et al.
Geographic variations in prevalence and underdiagnosis of COPD. Results of the IBERPOC multicentre epidemiological study
Chest
(2000) BTS guidelines for the management of community-acquired pneumonia in adults
Thorax
(2001)- et al.
New evidence of risk factors for community-acquired pneumonia: a population-based study
Eur Respir J
(2008) - et al.
Community-acquired pneumonia in chronic obstructive pulmonary disease: a Spanish multicenter study
Am J Respir Crit Care Med
(1996) - et al.
COPD is associated with increased mortality in patients with community-acquired pneumonia
Eur Respir J
(2006)
Implications of COPD in patients admitted to the intensive care unit by community-acquired pneumonia
Eur Respir J
C-reactive protein in patients with COPD, control smokers and non-smokers
Thorax
C-reactive protein levels in community-acquired pneumonia
Eur Respir J
New and emerging etiologies for community-acquired pneumonia with implications for therapy. A prospective multicenter study of 359 cases
Medicine
Standards for the diagnosis and management of patients with COPD
Cited by (87)
Where is Chlamydophila pneumoniae pneumonia?
2020, Respiratory InvestigationHospitalization due to community-acquired pneumonia in patients with chronic obstructive pulmonary disease: incidence, epidemiology and outcomes
2020, Clinical Microbiology and InfectionImpact of COPD on outcomes in hospitalized patients with community-acquired pneumonia: Analysis of the Spanish national hospital discharge database (2004–2013)
2017, European Journal of Internal MedicineCitation Excerpt :In addition, due to their underlying condition, COPD patients may seek medical care earlier, be admitted to hospital sooner, with a less severe CAP and receive more attention from physicians [14,18]. Despite it, some studies have found an association between COPD and increased mortality [9,10]. However, in a recent meta-analysis, Loke et al. [46] have concluded that evidence on associated mortality risk with concomitant CAP and COPD is weak and heterogeneous.
Prognosis of hospitalized patients with community-acquired pneumonia
2018, Revista Portuguesa de Pneumologia (English Edition)Citation Excerpt :Previous studies evaluating causes of death have shown that the absolute CAP-related mortality rate is low whereas malignancy and diseases of the circulatory and respiratory systems are the most common causes of death.10,13 At follow-up, COPD, malignancy, neurodegenerative disorders and cardiovascular diseases were shown to increase mortality.5,13,20–22 Charlson index score has been correlated independently with the long-term outcome.18,23
Novel protein biomarkers for pneumonia and acute exacerbations in COPD: a pilot study
2023, Frontiers in Medicine