Open AccessImpact of pneumonia on hospitalizations due to acute exacerbations of COPD
Author(s) -
Andreassen Siw Lillevik,
Liaaen Erik Dyb,
Stenfors Nikolai,
Henriksen Anne H.
Publication year - 2014
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12043
Subject(s) - medicine , copd , pneumonia , mechanical ventilation , pulmonary disease , mortality rate
Background and Aims Pneumonia is often diagnosed among patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease ( AECOPD ). The aims of this study were to find the proportion of patients with pneumonia among admissions due to AECOPD and whether pneumonia has impact on the length of stay ( LOS ), usage of non‐invasive ventilation ( NIV ) or the in‐hospital mortality. Methods Retrospectively, all hospitalizations in 2005 due to AECOPD in the D epartments of I nternal and R espiratory M edicine in one S wedish and two N orwegian hospitals were analyzed. A total of 1144 admittances (731 patients) were identified from patient administrative systems. Pneumonic AECOPD ( pAECOPD ) was defined as pneumonic infiltrates on chest X ‐ray and C ‐reactive protein ( CRP) value of ≥40 mg/ L , and non‐pneumonic AECOPD ( npAECOPD ) was defined as no pneumonic infiltrate on X ‐ray and CRP value of <40 at admittance. Results In admissions with pAECOPD ( n = 237), LOS was increased (median 9 days vs 5 days, P < 0.001) and usage of NIV was more frequent (18.1% vs 12.5%, P = 0.04), but no significant increase in the in‐hospital mortality (3.8% vs 3.6%) was found compared to admissions with np AECOPD . A higher proportion of those with COPD GOLD stage I – II had pAECOPD compared to those with COPD GOLD stage III–IV (28.2% vs 18.7%, P = 0.001). Conclusions In‐hospital morbidity, but not mortality, was increased among admissions with pAECOPD compared to npAECOPD . This may, in part, be explained by the extensive treatment with antibiotics and NIV in patients with pAECOPD .