Characteristics of community-acquired pneumonia in patients with chronic obstructive pulmonary disease

Pifarré, R.; Falguera, Miquel; Vicente-de-Vera, Carmina; Nogues, Antonio

doi:10.1016/j.rmed.2007.05.011

Cited by 63 publications

(43 citation statements)

References 23 publications

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“…This approach is in contrast to that of Pifarre et al [9], who studied pneumonia patients to gain insight into the characteristics of CAP in patients with COPD. To date, little data is available on the management and course of COPD patients with exacerbations who present acutely with or without pneumonia.…”

Section: Discussionmentioning

confidence: 98%

UK National COPD Resources and Outcomes Project 2008: Patients with Chronic Obstructive Pulmonary Disease Exacerbations Who Present with Radiological Pneumonia Have Worse Outcome Compared to Those with Non-Pneumonic Chronic Obstructive Pulmonary Disease Exacerbations

Myint

Lowe²,

Stone³

et al. 2011

Respiration

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Background: Limited comparative data exist on the outcomes of patients presenting with chronic obstructive pulmonary disease (COPD) exacerbations with or without radiological pneumonia. Objective: To examine the outcome differences amongst these patients. Methods: We analysed 2008 UK National COPD audit data to examine the characteristics, management and outcomes, inpatient- and 90-day mortality and length of stay of patients admitted with COPD exacerbations. Results: Of 9,338 admissions, 16% (1,505) had changes consistent with pneumonia indicated on the admission chest X-ray. They tended to be older (mean ages 75 vs. 72 years), male (53 vs. 50%), more likely to come from care homes, with more disability, higher BMI and co-morbidity, lower albumin but higher urea levels, and less likely to be current smokers. COPD exacerbations with pneumonia were associated with worse outcomes: inpatient mortality was 11 and 7% and 90-day mortality was 17 and 13% for pneumonia and non-pneumonia patients, respectively (p < 0.001). After adjusting for factors that are significantly different between the 2 groups, including age, sex, place of residence, level of disability, co-morbidity, albumin and urea levels, estimated risk ratios for inpatient and 90-day mortality for pneumonia compared to non-pneumonia cases in this series were 1.19 (1.01,1.42) and 1.09 (0.96,1.23), respectively. The adjusted risk ratio of a prolonged acute hospital stay of more than 7 days was 1.15 (1.07, 1.23). Conclusions: Patients who present with radiological pneumonia have worse outcomes compared to those admitted without pneumonia in exacerbation of COPD.

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Section: Discussionmentioning

confidence: 98%

UK National COPD Resources and Outcomes Project 2008: Patients with Chronic Obstructive Pulmonary Disease Exacerbations Who Present with Radiological Pneumonia Have Worse Outcome Compared to Those with Non-Pneumonic Chronic Obstructive Pulmonary Disease Exacerbations

Myint

Lowe²,

Stone³

et al. 2011

Respiration

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“…We failed to request missing data of interest by contacting the corresponding author of the original study. 23 The reviewers cross-checked all extracted data. Discrepancy between reviewers was resolved by discussion until consensus was reached.…”

Section: Data Extractionmentioning

confidence: 99%

“…All cohort studies ascertained the diagnosis of CAP based on chest radiographic findings, whereas the two case-control studies identified the cases of CAP according to the International Classification of Diseases (ICD-10) codes. Eight cohort studies confirmed the presence of COPD by spirometric criteria, 15,[18][19][20]23,[26][27][28] whereas the case-control studies 16,29 and one cohort study 17 identified COPD patients through medical records. The main characteristics of the included studies are summarized in Table 1.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Is COPD associated with increased mortality and morbidity in hospitalized pneumonia? A systematic review and meta‐analysis

et al. 2015

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This review aimed to investigate whether chronic obstructive pulmonary disease (COPD) is associated with increased mortality and morbidity in patients hospitalized with community-acquired pneumonia (CAP). EMBASE,PubMed and Web of Science were searched for cohort studies and case-control studies investigating the impact of COPD on CAP. The primary outcome was all-cause mortality, and secondary outcomes included length of hospital stay, intensive care unit (ICU) admission and need for mechanical ventilation. Methodological quality was assessed using the Newcastle-Ottawa Scale. The Mantel-Haenszel method and inverse variance method were used to calculate pooled relative risks (RRs) and mean differences (MD), respectively. Eleven studies (nine cohort studies and two casecontrol studies), involving 257 958 patients, were included. The overall methodological quality was high. COPD was not associated with increased mortality in hospitalized CAP patients (RR, 1.20; 95% confidence interval (CI): 0.92-1.56; P = 0.19; I 2 = 55%) in cohort studies, and was associated with reduced mortality in case-control studies (RR, 0.82; 95% CI: 0.74-0.90; P < 0.0001; I 2 = 80%). COPD was not associated with longer hospital stay (MD, 0.11; 95% CI: −0.42 to 0.64; P = 0.68; I 2 = 21%), more frequent ICU admission (RR, 0.97; 95% CI: 0.70-1.35; P = 0.87; I 2 = 65%), and more need for mechanical ventilation (RR 0.91, 95% CI: 0.71-1.16; P = 0.44; I 2 = 4%).The current available evidence indicates that COPD may not be associated with increased mortality and morbidity in patients hospitalized with CAP. This conclusion should be re-evaluated by prospective population-based cohort studies.

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“…Similar types of findings were also reported from Indian studies. 13 Identification and determining the clinical patterns and risk factors of Pneumonia (CAP) helps in adoption of regionally optimised diagnostic and therapeutic approach.…”

Section: Discussionmentioning

confidence: 99%

Study of Clinical Profile and Risk Factors of Pneumonia (Cap)

G¹,

N²,

P³

2017

jemds

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BACKGROUND Community-acquired pneumonia (CAP), the most common type of pneumonia is one of the commonest infectious diseases and is an important cause of mortality and morbidity in all age groups worldwide. Identifying people at risk for this infection aids in appropriate treatment. Hence, there is a need for a study to know the clinical profile and risk factors of pneumonia (CAP). Aim-To study the clinical profile and risk factors of pneumonia (CAP). MATERIALS AND METHODS50 patients who were admitted with pneumonia over a period of 7 months from 1 st January 2017 to 31 st July 2017 in King George Hospital, Visakhapatnam were studied retrospectively. RESULTSIn this study, majority of cases are males contributing 60%. CAP is commonly seen in the age group of 51-60 years (26%). The study shows that in young patients (age up to 50 years) cough with expectoration (34%) was the most common clinical feature followed by fever (32%) and breathlessness (22%), and among old patients (age above 50 years) fever (58%) was the most common clinical feature followed by cough with expectoration (40%) and breathlessness (22%). Pedal oedema, altered sensorium were present each as 4% but the former was seen in younger group and later was in older group. Among male patients smoking (56%) was the most common risk factor followed by alcohol (40%) and among female patients preceding diabetes (13%) was the most common risk factor. In the present study, the radiological finding (consolidation) was more common on right side constituting about 56% of the cases followed by left side (28%) and bilateral involvement in 16% cases. Right lower lobe involvement is more common in this study. Complications (20%) were more common in males and above 50 years. CONCLUSIONWorld Health Organization's (WHO) global burden of disease study estimated that lower respiratory tract infections (LRTIs), which include CAP, were 429.2 million. Commonly affected age group is 51-60 years which is the golden period in one's life. Patients, particularly elderly and debilitated having risk factors, should be instructed to seek prompt medical care during the early stages of dyspnoea or fever to prevent complications. Modifiable risk factors should be strictly corrected especially in those who also have fixed risk factors. Identification and determining the clinical patterns and risk factors of Pneumonia (CAP) helps in adoption of regionally optimised diagnostic and therapeutic approach.

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Characteristics of community-acquired pneumonia in patients with chronic obstructive pulmonary disease

Cited by 63 publications

References 23 publications

UK National COPD Resources and Outcomes Project 2008: Patients with Chronic Obstructive Pulmonary Disease Exacerbations Who Present with Radiological Pneumonia Have Worse Outcome Compared to Those with Non-Pneumonic Chronic Obstructive Pulmonary Disease Exacerbations

UK National COPD Resources and Outcomes Project 2008: Patients with Chronic Obstructive Pulmonary Disease Exacerbations Who Present with Radiological Pneumonia Have Worse Outcome Compared to Those with Non-Pneumonic Chronic Obstructive Pulmonary Disease Exacerbations

Is COPD associated with increased mortality and morbidity in hospitalized pneumonia? A systematic review and meta‐analysis

Study of Clinical Profile and Risk Factors of Pneumonia (Cap)

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