Infective Exacerbations of Chronic Obstructive Pulmonary Disease with or without Pneumonia

Objective: It was aimed to evaluate the relation between the presence of pneumonia and clinical, demographic and biochemical data of patients with a diagnosis of Chronic Obstructive Pulmonary Disease (COPD) during exacerbation in case-control groups.
Methods: The present study, which was designed as a prospective study, included COPD cases with or without pneumonia diagnosis, hospitalized between 2007 and 2008 in a tertiary chest diseases clinic for acute exacerbation. Patients that were diagnosed with pneumonia based on clinical and radiological findings at the time of hospitalization were assigned to the pneumonic exacerbation (PE) group and the cases without significant infiltration were assigned to the non-pneumonic exacerbation (n-PE) group. All patients were investigated in terms of demographic and biochemical data, as well as pulmonary function tests and time to exacerbation. Data were compared using chi-square test for categorical variables and student t-test for parametric variables, and a p <0.05 was considered significant. Relation between variables was analysed by Pearson correlation test.
Results: The study included 30 patients (23 males and 7 females; mean age±SD: 69±7 years) with signs of exacerbation without pneumonia and 30 COPD patients (23 males and 7 females; mean age±SD: 69±9 years) with a diagnosis of pneumonia. No difference was determined between the groups in terms of age, gender, presence of diabetes, number of annual exacerbations, and previous antibiotic use. The amount of cigarette smoking (59±36 pack.year versus 38±37 pack.year; p<0.05) was higher and disease duration (COPD) (15±11 years versus 7.7±8 years; p<0.05) was longer in the exacerbation group without pneumonia. Among laboratory findings, whilst there was no difference between the groups in terms of C-reactive protein (CRP), lactate dehydrogenase (LDH) and leukocyte counts, it was observed that forced expiratory volume in 1 second (FEV1) (33.5±10% versus 55±19%; p<0.05 ) was lower in the exacerbation group without pneumonia.
Conclusion: It is concluded that COPD patients who were more serious cigarette addicts, had a lower forced expiratory volume in 1 second (FEV1) and a longer disease duration are more prone to exacerbations without pneumonia.