Clinical features, etiology and outcomes of community-acquired pneumonia in patients with chronic obstructive pulmonary disease.

<h4>Background</h4>Community-acquired pneumonia (CAP) is a frequent complication of chronic obstructive pulmonary disease (COPD), but previous studies are often contradictory.<h4>Objectives</h4>We aimed to ascertain the characteristics and outcomes of CAP in patients with COP...

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Autores principales:	Joan Gómez-Junyent, Carolina Garcia-Vidal, Diego Viasus, Pere Millat-Martínez, Antonella Simonetti, Ma Salud Santos, Carmen Ardanuy, Jordi Dorca, Jordi Carratalà
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f94866768f5e4416b11fe18a6645e9af
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spelling	oai:doaj.org-article:f94866768f5e4416b11fe18a6645e9af2021-11-25T06:02:49ZClinical features, etiology and outcomes of community-acquired pneumonia in patients with chronic obstructive pulmonary disease.1932-620310.1371/journal.pone.0105854https://doaj.org/article/f94866768f5e4416b11fe18a6645e9af2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25166349/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Community-acquired pneumonia (CAP) is a frequent complication of chronic obstructive pulmonary disease (COPD), but previous studies are often contradictory.<h4>Objectives</h4>We aimed to ascertain the characteristics and outcomes of CAP in patients with COPD as well as to determine the risk factors for mortality and Pseudomonas aeruginosa pneumonia in COPD patients with CAP. We also describe the etiology and outcomes of CAP in COPD patients receiving chronic oxygen therapy at home and those receiving inhaled steroids.<h4>Methods</h4>An observational analysis of a prospective cohort of hospitalized adults with CAP (1995-2011) was performed.<h4>Results</h4>We documented 4121 CAP episodes, of which 983 (23.9%) occurred in patients with COPD; the median FEV1 value was 50%, and 57.8% were classified as stage III or IV in the GOLD classification. Fifty-eight per cent of patients were receiving inhaled steroids, and 14.6% chronic oxygen therapy at home. Patients with COPD presented specific clinical features. S. pneumoniae was the leading causative organism overall, but P. aeruginosa was more frequent in COPD (3.4 vs. 0.5%; p<0.001). Independent risk factors for case-fatality rate in patients with COPD were multilobar pneumonia, P. aeruginosa pneumonia, and high-risk PSI classes. Prior pneumococcal vaccination was found to be protective. FEV1 was an independent risk factor for P. aeruginosa pneumonia.<h4>Conclusions</h4>CAP in patients with COPD presents specific characteristics and risk factors for mortality. Prior pneumococcal vaccine has a beneficial effect on outcomes. P. aeruginosa pneumonia is associated with low FEV1 values and poor prognosis.Joan Gómez-JunyentCarolina Garcia-VidalDiego ViasusPere Millat-MartínezAntonella SimonettiMa Salud SantosCarmen ArdanuyJordi DorcaJordi CarratalàPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 8, p e105854 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Joan Gómez-Junyent Carolina Garcia-Vidal Diego Viasus Pere Millat-Martínez Antonella Simonetti Ma Salud Santos Carmen Ardanuy Jordi Dorca Jordi Carratalà Clinical features, etiology and outcomes of community-acquired pneumonia in patients with chronic obstructive pulmonary disease.
description	<h4>Background</h4>Community-acquired pneumonia (CAP) is a frequent complication of chronic obstructive pulmonary disease (COPD), but previous studies are often contradictory.<h4>Objectives</h4>We aimed to ascertain the characteristics and outcomes of CAP in patients with COPD as well as to determine the risk factors for mortality and Pseudomonas aeruginosa pneumonia in COPD patients with CAP. We also describe the etiology and outcomes of CAP in COPD patients receiving chronic oxygen therapy at home and those receiving inhaled steroids.<h4>Methods</h4>An observational analysis of a prospective cohort of hospitalized adults with CAP (1995-2011) was performed.<h4>Results</h4>We documented 4121 CAP episodes, of which 983 (23.9%) occurred in patients with COPD; the median FEV1 value was 50%, and 57.8% were classified as stage III or IV in the GOLD classification. Fifty-eight per cent of patients were receiving inhaled steroids, and 14.6% chronic oxygen therapy at home. Patients with COPD presented specific clinical features. S. pneumoniae was the leading causative organism overall, but P. aeruginosa was more frequent in COPD (3.4 vs. 0.5%; p<0.001). Independent risk factors for case-fatality rate in patients with COPD were multilobar pneumonia, P. aeruginosa pneumonia, and high-risk PSI classes. Prior pneumococcal vaccination was found to be protective. FEV1 was an independent risk factor for P. aeruginosa pneumonia.<h4>Conclusions</h4>CAP in patients with COPD presents specific characteristics and risk factors for mortality. Prior pneumococcal vaccine has a beneficial effect on outcomes. P. aeruginosa pneumonia is associated with low FEV1 values and poor prognosis.
format	article
author	Joan Gómez-Junyent Carolina Garcia-Vidal Diego Viasus Pere Millat-Martínez Antonella Simonetti Ma Salud Santos Carmen Ardanuy Jordi Dorca Jordi Carratalà
author_facet	Joan Gómez-Junyent Carolina Garcia-Vidal Diego Viasus Pere Millat-Martínez Antonella Simonetti Ma Salud Santos Carmen Ardanuy Jordi Dorca Jordi Carratalà
author_sort	Joan Gómez-Junyent
title	Clinical features, etiology and outcomes of community-acquired pneumonia in patients with chronic obstructive pulmonary disease.
title_short	Clinical features, etiology and outcomes of community-acquired pneumonia in patients with chronic obstructive pulmonary disease.
title_full	Clinical features, etiology and outcomes of community-acquired pneumonia in patients with chronic obstructive pulmonary disease.
title_fullStr	Clinical features, etiology and outcomes of community-acquired pneumonia in patients with chronic obstructive pulmonary disease.
title_full_unstemmed	Clinical features, etiology and outcomes of community-acquired pneumonia in patients with chronic obstructive pulmonary disease.
title_sort	clinical features, etiology and outcomes of community-acquired pneumonia in patients with chronic obstructive pulmonary disease.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/f94866768f5e4416b11fe18a6645e9af
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Clinical features, etiology and outcomes of community-acquired pneumonia in patients with chronic obstructive pulmonary disease.

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