title: Chronic obstructive pulmonary disease severity is associated with severe pneumonia.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a heterogeneous disorder, and various aspects of COPD may be associated with the severity of pneumonia in such patients.
  
  
  OBJECTIVE
  We examined the risk factors associated with severe pneumonia in a COPD population.
  
  
  METHODS
  We performed a retrospective observational study using a prospectively collected database of pneumonia patients who were admitted to our hospital through emergency department between 2008 and 2012. Patients with hospital-acquired pneumonia and those with an immunocompromised status were excluded.
  
  
  RESULTS
  Of 148 pneumonia patients with COPD for whom chest computed tomography (CT) scans were available, 106 (71.6%) and 42 (28.4%) were classified as non-severe and severe pneumonia, respectively. Multivariate logistic regression analysis revealed that the severity of airflow limitation [odds ratio (OR), 2.751; 95% confidence interval (CI), 1.074-7.050; P = 0.035] and the presence of emphysema on a chest CT scan (OR, 3.366; 95% CI, 1.104-10.265; P = 0.033) were independently associated with severe pneumonia in patients with COPD.
  
  
  CONCLUSIONS
  The severity of COPD including the airflow limitation grade and the presence of pulmonary emphysema were independently associated with the development of severe pneumonia.
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea ; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Jung Seop
authors.initials: JS
authors.lastname: Eom
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Won Jun
authors.initials: WJ
authors.lastname: Song
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hongseok
authors.initials: H
authors.lastname: Yoo
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Byeong-Ho
authors.initials: BH
authors.lastname: Jeong
authors.affiliation: Department of Radiology, Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Ho Yun
authors.initials: HY
authors.lastname: Lee
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Won-Jung
authors.initials: WJ
authors.lastname: Koh
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Kyeongman
authors.initials: K
authors.lastname: Jeon
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hye Yun
authors.initials: HY
authors.lastname: Park
keywords: Chronic obstructive pulmonary disease; emphysema; pneumonia; pulmonary function test; severity of illness
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