title: COPD is associated with increased mortality in patients with community-acquired pneumonia.
abstract: Patients with chronic obstructive pulmonary disease (COPD) who develop community-acquired pneumonia (CAP) may experience worse clinical outcomes. However, COPD is not included as a distinct diagnosis in validated instruments that predict mortality in patients with CAP. The aim of the present study was to evaluate the impact of COPD as a comorbid condition on 30- and 90-day mortality in CAP patients. A retrospective observational study was conducted at two hospitals. Eligible patients had a discharge diagnosis and radiological confirmation of CAP. Among 744 patients with CAP, 215 had a comorbid diagnosis of COPD and 529 did not have COPD. The COPD group had a higher mean pneumonia severity index score (105+/-32 versus 87+/-34) and were admitted to the intensive care unit more frequently (25 versus 18%). After adjusting for severity of disease and processes of care, CAP patients with COPD showed significantly higher 30- and 90-day mortality than non-COPD patients. Chronic obstructive pulmonary disease patients hospitalised with community-acquired pneumonia exhibited higher 30- and 90-day mortality than patients without chronic obstructive pulmonary disease. Chronic obstructive pulmonary disease should be evaluated for inclusion in community-acquired pneumonia prediction instruments.
authors.affiliation: The Veterans Evidence-based Research, Dissemination, and Implementation Center, Audie L. Murphy Veterans Hospital, San Antonio, TX 78284, USA. restrepom@uthscsa.edu
authors.forename: M I
authors.initials: MI
authors.lastname: Restrepo
authors.forename: E M
authors.initials: EM
authors.lastname: Mortensen
authors.forename: J A
authors.initials: JA
authors.lastname: Pugh
authors.forename: A
authors.initials: A
authors.lastname: Anzueto
mesh_terms: D017714:Community-Acquired Infections / Q000150:complications / Q000401:mortality*; D006785:Hospitals, University; D006801:Humans; D011014:Pneumonia / Q000150:complications / Q000401:mortality*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013781:Texas; D013997:Time Factors