Chronic obstructive pulmonary disease severity is associated with severe pneumonia

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.

We examined the risk factors associated with severe pneumonia in a COPD population.

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.

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.

The severity of COPD including the airflow limitation grade and the presence of pulmonary emphysema were independently associated with the development of severe pneumonia.