Open AccessClinical relevance of emphysema in patients hospitalized with community‐acquired pneumonia: Clinical features and prognosis
Author(s) -
Seo Hyewon,
Cha SeungIck,
Shin Kyung Min,
Lim Jae Kwang,
Lee Won Kee,
Park JiEun,
Park Sunji,
Choi Sun Ha,
Lee YongHoon,
Yoo SeungSoo,
Lee ShinYup,
Lee Jaehee,
Kim ChangHo,
Park JaeYong
Publication year - 2021
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.13370
Subject(s) - medicine , empyema , pneumonia , community acquired pneumonia , incidence (geometry) , parapneumonic effusion , pleural effusion , pneumonia severity index , etiology , retrospective cohort study , streptococcus pneumoniae , surgery , antibiotics , pleural fluid , physics , microbiology and biotechnology , optics , biology
Few studies have investigated the influence of emphysema on clinical features of patients presenting with community‐acquired pneumonia (CAP). Objectives The aim of this study was to examine the clinical and microbiological features of patients with both CAP and emphysema. Methods This retrospective study included patients with CAP who underwent computed tomography (CT) scan at the time of presentation. Patients were allocated into emphysema and control groups, and clinical variables were compared between the two groups. The emphysema group was further divided into three subgroups (mild, moderate, and severe) according to the extent of emphysema on CT scan. The clinical variables of each subgroup were compared with the control group. Results Of 1676 patients, 431 patients (25.7%) were classified into the emphysema group. CAP patients with emphysema were more likely to have a high CURB‐65 score and pneumonia severity index and a lower incidence of complicated parapneumonic effusion or empyema. The emphysema group exhibited longer hospital stay. In addition, 30‐day mortality in the severe emphysema group was significantly higher compared with the control group. As etiological agents, Streptococcus pneumoniae, Pseudomonas aeruginosa , Enterobacteriaceae , and multidrug‐resistant pathogens were significantly more common in the emphysema group compared with the control group. Conclusions The presence of emphysema in CAP patients was associated with a more severe form of CAP, a longer hospital stay, and a lower incidence of complicated parapneumonic effusion or empyema. Moreover, CAP patients with severe emphysema exhibited higher 30‐day mortality than those without emphysema.