Impact of pneumonia on hospitalizations due to acute exacerbations of COPD

Authors

  • Siw Lillevik Andreassen,

    1. Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
    Search for more papers by this author
  • Erik Dyb Liaaen,

    1. Department of Internal Medicine, Aalesund Hospital, Aalesund, Norway
    Search for more papers by this author
  • Nikolai Stenfors,

    1. Division of Medicine, Department of Public health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå, Sweden
    Search for more papers by this author
  • Anne H. Henriksen

    Corresponding author
    1. Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
    2. Department of Thoracic- and Occupational Medicine, Trondheim University Hospital, Trondheim, Norway
    • Correspondence

      Anne Hildur Henriksen, MD PhD, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Olav Kyrres Gate 17, 7030,

      Trondheim, Norway.

      Fax: +47 72829699

      email: anne.hildur.henriksen@stolav.no

    Search for more papers by this author

  • Authorship and contributorship
  • All authors of the present manuscript have contributed substantially to the design, performance analysis and reporting of the work.
  • Ethics
  • This study was approved by the Regional Ethics Committee.
  • Conflict of interest
  • The authors have no conflict of interest to declare.

Abstract

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 Departments of Internal and Respiratory Medicine in one Swedish and two Norwegian 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 npAECOPD. 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.

Ancillary