Pneumonia as Comorbidity in Chronic Obstructive Pulmonary Disease (COPD). Differences Between Acute Exacerbation of COPD and Pneumonia in Patients With COPD |
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| Institution: | 1. Servicio de Medicina Interna, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Barcelona, Spain;2. Unidad de Neumología, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Barcelona, Spain;3. Unidad de Cuidados Intensivos, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Barcelona, Spain;4. Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain;1. TRIUMF, 4004 Wesbrook Mall, Vancouver, BC V6T 2A3, Canada;2. Department of Physics and Astronomy, University of Manitoba, Winnipeg, MB R3T 2N2, Canada;3. Racah Institute of Physics, The Hebrew University, Jerusalem 9190401, Israel;1. Servicio de Neumología y Alergia Respiratoria, Institut Clínic del Tòrax, Hospital Clínic, Barcelona, España;2. División de Insuficiencia Cardíaca e Hipertensión Pulmonar, Instituto de Cardiología de Corrientes, Corrientes, Argentina;3. Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, España;4. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, España;5. Servicio de Cirugía Cardiovascular, Institut Clínic del Tòrax, Hospital Clínic, Barcelona, España;6. Servicio de Anestesiología y Reanimación, Hospital Clínic, Universidad de Barcelona, Barcelona, España;1. Department of Pulmonology, Hospital Clinic of Barcelona, University of Barcelona, Institut D''investigacions August Pi I Sunyer (IDIBAPS), Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain;2. Respiratory Intensive Care Unit, Pulmonary Division, Heart Institute, Hospital das Clínicas, University of Sao Paulo, Sao Paulo, Brazil;1. Department of Clinical and Experimental Sciences and Respiratory Biomedical Research Unit, University of Southampton, UK;2. Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK;3. Public Health England Clinical Microbiology and Public Health Laboratory, Addenbrooke''s Hospital, Cambridge, UK;1. Croatian Institute of Public Health, Zagreb, Croatia;2. The University of Zagreb, School of Medicine, The ‘Andrija ?tampar’ School of Public Health, Zagreb, Croatia;1. Department of Medicine, National Jewish Health, Denver, CO;2. Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, CO;3. Department of Mathematical and Statistical Sciences, University of Colorado Denver, Denver, CO;4. Department of Medicine, Section of Pulmonary and Critical Care Medicine, Temple University, Philadelphia PA;5. Department of Medicine and the Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, CO;6. Channing Division of Network Medicine, Division of Pulmonary and Critical Care, Department of Medicine, Brigham and Women''s Hospital, Boston, MA;7. Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of California at San Diego, La Jolla, CA;8. Department of Internal Medicine, University of Michigan, Ann Arbor, MI;9. Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, and South Texas Veterans Health Care System, San Antonio, TX;10. University of Iowa, Iowa City, IA;11. University of Alabama at Birmingham, Birmingham, AL;12. Duke University Medical Center, Durham, NC;13. University of Minnesota, Minneapolis, MN;14. University of Pittsburgh Medical Center, Pittsburgh, PA;15. Baylor College of Medicine, Houston, TX;p. Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, Scotland;q. Johns Hopkins University, Baltimore, MD |
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| Abstract: | IntroductionPneumonia is considered an independent entity in chronic obstructive pulmonary disease (COPD), to be distinguished from an infectious exacerbation of COPD. The aim of this study was to analyze the clinical characteristics and progress of the exacerbation of COPD (ECOPD) compared to pneumonia in COPD (PCOPD) patients requiring hospitalization.Patients and methodsProspective, longitudinal, observational cohort study including 124 COPD patients requiring hospital admission for lower respiratory tract infection. Patients were categorized according to presence of ECOPD (n=104) or PCOPD (n=20), depending on presence of consolidation on X-ray. Demographic, clinical, laboratory, microbiological and progress variables were collected.ResultsPatients with ECOPD showed more severe respiratory disease according to the degree of obstruction (P<.01) and need for oxygen therapy (P<.05). PCOPD patients showed increased presence of fever (P<.05), higher blood pressure (P<.001), more laboratory abnormalities (P<.05; leukocytosis, elevated CRP, low serum albumin) and increased presence of crepitus (P<.01). Microbiological diagnosis was achieved in 30.8% of cases of ECOPD and 35% of PCOPD; sputum culture yielded the highest percentage of positive results, predominantly Pseudomonas aeruginosa. Regarding the progress of the episode, no differences were found in hospital stay, need for ICU or mechanical ventilation.ConclusionsOur data confirm clinical and analytical differences between ECOPD and PCOPD in patients who require hospital admission, while there were no differences in subsequent progress. |
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| Keywords: | Chronic obstructive pulmonary disease Respiratory infection Acute exacerbation Pneumonia Hospitalization Enfermedad pulmonar obstructiva crónica Infección respiratoria Exacerbación aguda Neumonía Hospitalización |
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