scholarly journals Pneumonic versus Nonpneumonic Exacerbations of Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 41 (06) ◽  
pp. 817-829
Author(s):  
Ernesto Crisafulli ◽  
Alessandra Manco ◽  
Miquel Ferrer ◽  
Arturo Huerta ◽  
Claudio Micheletto ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Inflammatory Response ◽  
Pulmonary Disease ◽  
Defense Mechanisms ◽  
Community Acquired Pneumonia ◽  
Systemic Inflammatory Response ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Reactive Protein ◽  
The Impact

AbstractPatients with chronic obstructive pulmonary disease (COPD) often suffer acute exacerbations (AECOPD) and community-acquired pneumonia (CAP), named nonpneumonic and pneumonic exacerbations of COPD, respectively. Abnormal host defense mechanisms may play a role in the specificity of the systemic inflammatory response. Given the association of this aspect to some biomarkers at admission (e.g., C-reactive protein), it can be used to help to discriminate AECOPD and CAP, especially in cases with doubtful infiltrates and advanced lung impairment. Fever, sputum purulence, chills, and pleuritic pain are typical clinical features of CAP in a patient with COPD, whereas isolated dyspnea at admission has been reported to predict AECOPD. Although CAP may have a worse outcome in terms of mortality (in hospital and short term), length of hospitalization, and early readmission rates, this has only been confirmed in a few prospective studies. There is a lack of methodologically sound research confirming the impact of severe AECOPD and COPD + CAP. Here, we review studies reporting head-to-head comparisons between AECOPD and CAP + COPD in hospitalized patients. We focus on the epidemiology, risk factors, systemic inflammatory response, clinical and microbiological characteristics, outcomes, and treatment approaches. Finally, we briefly discuss some proposals on how we should orient research in the future.

Impact of chronic obstructive pulmonary disease on mortality in community acquired pneumonia: a meta-analysis

2020 ◽  
Vol 9 (12) ◽  
pp. 839-848
Author(s):  
Hui Ma ◽  
Ting Liu ◽  
Yongxiang Zhang ◽  
Zhen Ye ◽  
Wei Jia ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Meta Analysis ◽  
Positive Association ◽  
Community Acquired Pneumonia ◽  
Cochrane Library ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Short And Long Term ◽  
The Impact

Background: The aim of the present study was to systematically review the exiting literature and to proceed a meta-analysis to determine the impact of chronic obstructive pulmonary disease (COPD) on mortality in patients with community acquired pneumonia. Materials & methods: Eligible studies were searched from PubMed, Cochrane Library and EMBASE. Odds ratios (ORs) with 95% CIs were used as effect estimates. Results: Twenty cohort studies were included. Analysis of unadjusted data revealed nonsignificant short- and long-term mortality associated with COPD. Analysis of adjusted 30-days mortality showed similarly no association between COPD and increased 30-days mortality (OR: 1.06, [0.68, 1.44]) but a positive association when COPD was confirmed spirometrically (OR: 1.84, [1.06, 2.62]). Conclusion: There is still no evidence to clear the impact of COPD on mortality in patients with community acquired pneumonia. More prospective studies with spirometrically-defined COPD and adequate adjustment for confounders are needed.

scholarly journals The Impact of Community-acquired Pneumonia on Acute Exacerbation of Chronic Obstructive Pulmonary Disease Patients as Regards In-hospital Complications and Early Readmission

2020 ◽  
Vol 14 (1) ◽  
pp. 10-15
Author(s):  
Dina Ruby
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Community Acquired Pneumonia ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Early Readmission ◽  
The Impact

Background and Objective: Pneumonia is a major reason for hospitalization for Acute Exacerbation of Chronic Obstructive Pulmonary Disease patients (AECOPD). There is limited data available on the outcomes of AECOPD patients with or without pneumonia. Therefore, the study investigates the prognosis of AECOPD patients with or without Community-acquired Pneumonia (CAP), concerning the Length of Hospital Stay (LOS), in-hospital complications and early readmission. Methods: This study was carried out on 100 male COPD patients without CAP, 90 patients with CAP who were admitted to the chest department of Ain Shams University hospital over a 1-year period. Data collection about LOS, in-hospital complications, was recorded and they were followed for 30 days to detect acute readmission. Results: The mean age was 64± 8 years old in COPD patients without CAP to 62± 12year old in patients with CAP, LOS in COPD patients with CAP was 11.30 ± 3.23 days to 7.57 ± 2.24 in patients without CAP, COPD patients with CAP had a higher rate of complications in comparison to those without CAP as 45.6%, 13% were admitted to Intensive Care Unit (ICU) respectively, 15.6%, 3% were mechanically ventilated respectively. LOS and C- Reactive Protein (CRP) were significant causes for readmission in COPD patients with and without CAP. Conclusion: COPD patients with CAP had longer LOS and more short term complications as ICU admission, mechanical ventilation and higher readmission rate in comparison to COPD patients without CAP.

scholarly journals Combination of community acquired pneumonia with chronic obstructive pulmonary disease: clinical peculiarities, production of active oxygen forms, general antioxidant blood status

2019 ◽  
Vol 91 (3) ◽  
pp. 42-45
Author(s):  
U R Farkhutdinov ◽  
E F Amirova ◽  
R R Farkhutdinov
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Clinical Symptoms ◽  
Laboratory Data ◽  
Community Acquired Pneumonia ◽  
Active Oxygen ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Active Oxygen Forms ◽  
Reactive Protein

Aim. The objective is to study clinical peculiarities, production of active oxygen forms and general antioxidant blood status in patients with community acquired pneumonia and in its combination with chronic obstructive pulmonary disease. Materials and methods. 59 patients hospitalized in patient department took part in the study. The first group included 32 patients with community acquired pneumonia (CAP).The second group included 27 patients with combination of community acquired pneumonia and chronic obstructive pulmonary disease (CAP+COPD). Symptoms of the disease, clinico-laboratory data and findings of the instrumental investigations were analyzed in the patients. Production of active oxygen forms (AOF) in the whole blood was studied. General antioxidant status (AOS) was analyzed in the blood serum. Results and discussion. The values of prognostic CRB-65 scale and clinical index of the severity of the condition were higher in patients with CAP+COPD compared to the patients with CAP. The reduction of spontaneous and induced by pyrogenal chemiluminescence (ChL) of blood has been found in the patients; this fact indicates decreased production of AOF by the cells. In patients with CAP general AOS of the blood was found to be increased but in patients with CAP+COPD it was decreased. After the course of treatment in patients with CAP+COPD symptoms of the disease remained, the level of C-reactive protein in serum was high and the level of AOS of blood was low, disturbances in the AOF production were observed. Conclusion. In patients with CAP+COPD in comparison with CAP patients the intensity of clinical symptoms was higher, the inflammatory process had a prolonged character, disturbances in the production of AOF and AOS of blood were more marked.

scholarly journals Procalcitonin and CRP as Biomarkers in Discrimination of Community-Acquired Pneumonia and Exacerbation of COPD

2017 ◽  
Vol 36 (2) ◽  
pp. 122-126 ◽  
Author(s):  
Ayfer Çolak ◽  
Celalettin Yılmaz ◽  
Burak Toprak ◽  
Serir Aktoğu
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Community Acquired Pneumonia ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Reactive Protein ◽  
Group 2 ◽  
Exacerbation Of Copd ◽  
Tract Infections ◽  
Serum Crp

Summary Background: Serum procalcitonin (PCT) and C-reactive protein (CRP) are markers of systemic inflammation and bacterial infection. We aimed to compare the usefulness of procalcitonin and CRP in patients with communityacquired pneumonia and exacerbations of chronic obstructive pulmonary disease (COPD). Methods: A total of 116 consecutive patients were included in the study: 76 with chronic obstructive pulmonary disease in group 1, and 40 with pneumonia in group 2. Results: Median serum CRP level was 44 mg/L in the COPD group and 132 mg/L in the pneumonia group. Median value of serum PCT was found to be 0.07 in the COPD group and 0.14 ng/mL in the pneumonia group. Serum PCT and CRP levels were significantly higher in the pneumonia group compared to the COPD group (p<0.001). The area under the ROC curve was 0.788 (Cl: 0.704-0.872) for CRP and 0.699 (Cl: 0.599-0.800) for procalcitonin to identify pneumonia. Conclusions: Procalcitonin and CRP levels were significantly higher in patients with community-acquired pneumonia presenting to the emergency department with indications for hospitalization than in patients with exacerbations of chronic obstructive pulmonary disease. Serum CRP and procalcitonin concentrations were strongly correlated. CRP might be a more valuable marker in these patients with lower respiratory tract infections.

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