Influence of pneumonia on the survival of patients with COPD

Introduction: Pneumonia is a frequent infection. Chronic obstructive pulmonary disease (COPD) can present with comorbidities, including pneumonia. It’s known that COPD worsens the evolution of pneumonia, but there are few studies focused on COPD patients where the impact of pneumonia on its evolution is described. This study analyzes the influence of pneumonia on the survival of COPD patients. Methods: Observational study of a cohort of 273 patients with COPD who attended spirometry in 2011, with a prospective follow-up of 6 years. Patients were divided into two groups according to the acquisition or not of pneumonia during follow-up. The difference in survival between both was analyzed. Results: Survival was lower in the group with pneumonia compared to whose without pneumonia (p=0.000), both globally and stratified by COPD phenotypes. Pneumonia (HR 2.50; 95% CI 1.53-4.08, p=0.000), advanced age (HR 1.05; 95% CI 1.03-1.08, p=0.000), chronic bronchitis (HR 2.20; 95% CI 1.03-4.69, p=0.041), long-term oxygen therapy (HR 2.21; 95% CI 1.40-3.51, p=0.001) and high Charlson index (HR 1.31; 95% CI 1.17-1.47, p=0.000) were identified as risk factors independently associated with mortality, while a high body mass index (HR 0.91; 95% CI 0.87-0.96, p=0.000) was identified as a protective factor. Conclusions: Having pneumonia causes to worse prognosis in COPD patients, so it’s important to take into account this comorbidity in comprehensive care for these patients.