No difference in long term survival in patients hospitalized for pneumonic versus non‐pneumonic acute exacerbations of <scp>COPD</scp>

Stenfors, Nikolai; Liaaen, Erik Dyb; Henriksen, Anne Hildur

doi:10.1111/crj.12636

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…The mortality rate recorded in the present study is higher than that for patients with COPD admitted to hospital (7-19%) [82,83] and intensive and critical care units (12%) [82], and lower than that for patients with severe COPD receiving integrated care (39%) [84]. One explanation for the high mortality rate may be the high prevalence rate of very severe COPD (GOLD IV) (46%) [84].…”

Section: Discussioncontrasting

confidence: 61%

Changes in and predictors of pain and mortality in patients with chronic obstructive pulmonary disease

Bentsen

Holm

Christensen

et al. 2020

Respiratory Medicine

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This longitudinal study of patients with chronic obstructive pulmonary disease (COPD) aimed to investigate changes in pain characteristics (i.e., occurrence, intensity, and interference) and covariates associated with pain from study enrollment to 12 months, and to investigate if the different pain characteristics were associated with 5-year mortality. In total, 267 patients with COPD completed questionnaires five times over 1 year. The mean age of the patients was 63 years (standard deviation: 9.0), 53% were women, and 46% had very severe COPD. Median number of comorbidities was 2.0 (range: 0-11) and 47% of patients reported back/neck pain.Mixed models and Cox regression models were used for analyses. In total, 60% of the patients reported pain at baseline, and 61% at 12 months. The mixed model analyses revealed that those with better forced expiratory volume in 1 second (% predicted), more comorbidities, only primary school education, and more respiratory symptoms reported significantly higher average pain intensity. Moreover, those with more comorbidities, more respiratory symptoms, and more depression reported higher pain interference with function. At the 5-year follow-up, 64 patients (24%) were deceased, and the cumulative 5-year mortality rate was 22% (95% confidence interval [19][20][21][22][23][24][25]). Older age, lower forced expiratory volume in 1 second (% predicted), and higher pain interference at enrollment were all independently and significantly associated with higher 5-year mortality. Our findings show that many patients with COPD have persistent pain, and awareness regarding comorbidities and how pain interferes with their lives is needed.

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Section: Discussioncontrasting

confidence: 61%

Changes in and predictors of pain and mortality in patients with chronic obstructive pulmonary disease

Bentsen

Holm

Christensen

et al. 2020

Respiratory Medicine

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“…51 AECOPD þ CAP and AECOPD also did not differ with respect to the need of NIMV ICU admission, 63 or mortality during hospitalization, 59 at 1 63 and 5 years. 121 However, a prospective study 60 reported a worse cumulative survival at 6 months for AECOPD þ CAP compared with AECOPD alone (HR ¼ 1.98; 95% CI: 1.16-3.37; p ¼ 0.012); interestingly, this effect was influenced by early readmission. 60 With regard to critical COPD patients admitted to ICU the risk rate of death due to CAP was significantly high (HR 1.27; 95% CI 1.01 to 1.59) 12 : 59% of reasons for ICU mortality were related to CAP.…”

Section: Discussionmentioning

confidence: 98%

Pneumonic versus Nonpneumonic Exacerbations of Chronic Obstructive Pulmonary Disease

Crisafulli

Manco

Ferrer

et al. 2020

Semin Respir Crit Care Med

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Patients with chronic obstructive pulmonary disease (COPD) often suffer acute exacerbations (AECOPD) and community-acquired pneumonia (CAP), named nonpneumonic and pneumonic exacerbations of COPD, respectively. Abnormal host defense mechanisms may play a role in the specificity of the systemic inflammatory response. Given the association of this aspect to some biomarkers at admission (e.g., C-reactive protein), it can be used to help to discriminate AECOPD and CAP, especially in cases with doubtful infiltrates and advanced lung impairment. Fever, sputum purulence, chills, and pleuritic pain are typical clinical features of CAP in a patient with COPD, whereas isolated dyspnea at admission has been reported to predict AECOPD. Although CAP may have a worse outcome in terms of mortality (in hospital and short term), length of hospitalization, and early readmission rates, this has only been confirmed in a few prospective studies. There is a lack of methodologically sound research confirming the impact of severe AECOPD and COPD + CAP. Here, we review studies reporting head-to-head comparisons between AECOPD and CAP + COPD in hospitalized patients. We focus on the epidemiology, risk factors, systemic inflammatory response, clinical and microbiological characteristics, outcomes, and treatment approaches. Finally, we briefly discuss some proposals on how we should orient research in the future.

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Effect of Community-Acquired Pneumonia on Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Niu

Xing

et al. 2021

COPD: Journal of Chronic Obstructive Pulmonary Disease

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No difference in long term survival in patients hospitalized for pneumonic versus non‐pneumonic acute exacerbations of COPD

Cited by 3 publications

References 7 publications

Changes in and predictors of pain and mortality in patients with chronic obstructive pulmonary disease

Changes in and predictors of pain and mortality in patients with chronic obstructive pulmonary disease

Pneumonic versus Nonpneumonic Exacerbations of Chronic Obstructive Pulmonary Disease

Effect of Community-Acquired Pneumonia on Acute Exacerbation of Chronic Obstructive Pulmonary Disease

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