Authorship and contributorship
Impact of pneumonia on hospitalizations due to acute exacerbations of COPD
Article first published online: 1 OCT 2013
© 2013 John Wiley & Sons Ltd
The Clinical Respiratory Journal
Volume 8, Issue 1, pages 93–99, January 2014
How to Cite
Andreassen, S. L., Liaaen, E. D., Stenfors, N. and Henriksen, A. H. (2014), Impact of pneumonia on hospitalizations due to acute exacerbations of COPD. The Clinical Respiratory Journal, 8: 93–99. doi: 10.1111/crj.12043
All authors of the present manuscript have contributed substantially to the design, performance analysis and reporting of the work.
This study was approved by the Regional Ethics Committee.
Conflict of interest
The authors have no conflict of interest to declare.
- Issue published online: 6 JAN 2014
- Article first published online: 1 OCT 2013
- Accepted manuscript online: 25 JUL 2013 04:41AM EST
- Manuscript Accepted: 9 JUL 2013
- Manuscript Revised: 12 JUN 2013
- Manuscript Received: 3 JAN 2013
- COPD ;
- exacerbations ;
- hospitalizations ;
- NIV ;
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.
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.
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).
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.