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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">TO study the incidence&#44; severity&#44; and mortality rates of pneumonia in a cohort of chronic obstructive pulmonary disease &#40;COPD&#41; patients monitored over 3 years&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 596 patients diagnosed with COPD according to spirometric criteria were included in the study&#46; The variables assessed were mortality and severity according to the Pneumonia Severity Index &#40;PSI&#41; for community-acquired pneumonia &#40;CAP&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Of the 596 patients included in the study&#44; 75 &#40;12&#46;6&#37;&#41; developed at least 1 episode of pneumonia during the 3 years of the study&#46; The overall incidence of pneumonia was 55&#46;1 per 1000 person-years&#46; There were 88 episodes in 75 patients&#46; COPD severity&#44; evaluated based on percentage of predicted FEV<span class="elsevierStyleInf">1</span>&#44; was mild in 9 patients&#44; moderate in 24&#44; and severe in 42&#46; Seventy-six &#40;86&#46;3&#37;&#41; episodes were CAP and 12 &#40;13&#46;6&#37;&#41; were acquired in hospital&#46; Fourteen CAP cases corresponded to PSI group V&#44; 28 to group IV&#44; 20 to group III&#44; and 14 to groups I and II&#46; Overall mortality was 12&#46;5&#37; &#40;11&#47;88&#41;&#46; The mortality rate was 41&#46;7&#37; &#40;5&#47;12&#41; for nosocomial cases and 7&#46;8&#37; &#40;6&#47;76&#41; for CAP cases &#40;OR&#44; 6&#46;67&#59; 95&#37; confidence interval&#44; 1&#46;65-26&#46;93&#41;&#46; Assessing CAP mortality by level of severity&#44; we found that the mortality rate was 35&#46;7&#37; &#40;5&#47;14&#41; for group V and 3&#46;5&#37; &#40;1&#47;28&#41; for group IV&#46; No deaths occurred among patients in the other severity groups&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The incidence of pneumonia in COPD patients is high&#46; More than half the cases of CAP &#40;55&#46;2&#37;&#41; in our COPD patients were classified in PSI risk groups IV and V&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Estudiar la incidencia&#44; gravedad y mortalidad de las neumon&#237;as ocurridas en una cohorte de pacientes con enfermedad pulmonar obstructiva cr&#243;nica &#40;EPOC&#41; seguidos durante 3 a&#241;os&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; en el estudio a 596 pacientes con diagn&#243;stico espirom&#233;trico de EPOC&#46; Los par&#225;-metros a evaluar fueron la mortalidad y la gravedad valora-da de acuerdo con el Pneumonia Severity Index &#40;PSI&#41; para la neumon&#237;a adquirida en la comunidad &#40;NAC&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">De 596 pacientes incluidos en el estudio&#44; 75 &#40;12&#44;6&#37;&#41; desarrollaron al menos un episodio de neumon&#237;a durante el seguimiento&#46; La incidencia global de neumon&#237;a fue de 55&#44;1 por 1&#46;000 personas-a&#241;o&#46; Hubo 88 episodios en 75 pacientes&#46; El grado de la EPOC&#44; valorado seg&#250;n el FEV<span class="elsevierStyleInf">1</span> como porcentaje del te&#243;rico&#44; era en 9 pacientes leve&#44; en 24 moderado y en 42 grave&#46; De los episodios de neumon&#237;a&#44; 76 &#40;86&#44;3&#37;&#41; fueron adquiridos en la comunidad y 12 &#40;13&#44;6&#37;&#41; en el hospital&#46; Al valorar la gravedad de la NAC&#44; 14 episodios correspond&#237;an al grupo V&#44; 28 al grupo IV&#44; 20 al grupo III y 14 a los grupos I y II&#46; La mortalidad global fue del 12&#44;5&#37; &#40;11&#47;88&#41;&#46; La mortalidad en las neumon&#237;as nosocomiales fue del 41&#44;7&#37; &#40;5&#47;12&#41; y la mortalidad en las NAC fue del 7&#44;8&#37; &#40;6&#47;76&#41; &#40;OR&#58; 6&#44;67&#59; intervalo de confianza del 95&#37;&#44; 1&#44;65-26&#44;93&#41;&#46; Al valorar la mortalidad en las NAC seg&#250;n la gravedad&#44; se encontr&#243; que la mortalidad en el grupo V fue de un 35&#44;7&#37; &#40;5&#47;14&#41;&#44; en el grupo IV del 3&#44;5&#37; &#40;1&#47;28&#41; y nula en el res-to de los grupos&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Hay una elevada incidencia de neumon&#237;a en los pacientes con EPOC&#46; M&#225;s de la mitad de las NAC &#40;55&#44;2&#37;&#41; ocurridas en nuestros pacientes con EPOC est&#225;n dentro de los grupos de riesgo del PSI IV y V&#46;</p>"
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Journal Information
Vol. 41. Issue 11.
Pages 607-611 (November 2005)
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Vol. 41. Issue 11.
Pages 607-611 (November 2005)
Original Articles
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Prognosis in Patients With Pneumonia and Chronic Obstructive Pulmonary Disease
Visits
12498
M. Merino-Sánchez
Corresponding author
mercedesmerino@terra.es
ialfageme@separ.es

Correspondence: Dra. M. Merino Sánchez. Servicio de Neumología. Hospital Universitario de Valme. Ctra. de Cádiz, s/n. 41014 Sevilla. España
, I. Alfageme-Michavila, N. Reyes-Núñez, J. Lima-Álvarez
Servicio de Neumología, Hospital Universitario de Valme, Sevilla, Spain
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Objective

TO study the incidence, severity, and mortality rates of pneumonia in a cohort of chronic obstructive pulmonary disease (COPD) patients monitored over 3 years.

Patients and methods

A total of 596 patients diagnosed with COPD according to spirometric criteria were included in the study. The variables assessed were mortality and severity according to the Pneumonia Severity Index (PSI) for community-acquired pneumonia (CAP).

Results

Of the 596 patients included in the study, 75 (12.6%) developed at least 1 episode of pneumonia during the 3 years of the study. The overall incidence of pneumonia was 55.1 per 1000 person-years. There were 88 episodes in 75 patients. COPD severity, evaluated based on percentage of predicted FEV1, was mild in 9 patients, moderate in 24, and severe in 42. Seventy-six (86.3%) episodes were CAP and 12 (13.6%) were acquired in hospital. Fourteen CAP cases corresponded to PSI group V, 28 to group IV, 20 to group III, and 14 to groups I and II. Overall mortality was 12.5% (11/88). The mortality rate was 41.7% (5/12) for nosocomial cases and 7.8% (6/76) for CAP cases (OR, 6.67; 95% confidence interval, 1.65-26.93). Assessing CAP mortality by level of severity, we found that the mortality rate was 35.7% (5/14) for group V and 3.5% (1/28) for group IV. No deaths occurred among patients in the other severity groups.

Conclusions

The incidence of pneumonia in COPD patients is high. More than half the cases of CAP (55.2%) in our COPD patients were classified in PSI risk groups IV and V.

Key Words:
Chronic obstructive pulmonary disease (COPD)
Pneumonia
Mortality
Epidemiology
Incidence
Objetivo

Estudiar la incidencia, gravedad y mortalidad de las neumonías ocurridas en una cohorte de pacientes con enfermedad pulmonar obstructiva crónica (EPOC) seguidos durante 3 años.

Pacientes y métodos

Se incluyó en el estudio a 596 pacientes con diagnóstico espirométrico de EPOC. Los pará-metros a evaluar fueron la mortalidad y la gravedad valora-da de acuerdo con el Pneumonia Severity Index (PSI) para la neumonía adquirida en la comunidad (NAC).

Resultados

De 596 pacientes incluidos en el estudio, 75 (12,6%) desarrollaron al menos un episodio de neumonía durante el seguimiento. La incidencia global de neumonía fue de 55,1 por 1.000 personas-año. Hubo 88 episodios en 75 pacientes. El grado de la EPOC, valorado según el FEV1 como porcentaje del teórico, era en 9 pacientes leve, en 24 moderado y en 42 grave. De los episodios de neumonía, 76 (86,3%) fueron adquiridos en la comunidad y 12 (13,6%) en el hospital. Al valorar la gravedad de la NAC, 14 episodios correspondían al grupo V, 28 al grupo IV, 20 al grupo III y 14 a los grupos I y II. La mortalidad global fue del 12,5% (11/88). La mortalidad en las neumonías nosocomiales fue del 41,7% (5/12) y la mortalidad en las NAC fue del 7,8% (6/76) (OR: 6,67; intervalo de confianza del 95%, 1,65-26,93). Al valorar la mortalidad en las NAC según la gravedad, se encontró que la mortalidad en el grupo V fue de un 35,7% (5/14), en el grupo IV del 3,5% (1/28) y nula en el res-to de los grupos.

Conclusiones

Hay una elevada incidencia de neumonía en los pacientes con EPOC. Más de la mitad de las NAC (55,2%) ocurridas en nuestros pacientes con EPOC están dentro de los grupos de riesgo del PSI IV y V.

Palabras clave:
Enfermedad pulmonar obstructiva crónica (EPOC)
Neumonía
Mortalidad
Epidemiología
Incidencia
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Financed by Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and Servicio Andaluz de Salud (53/99).

Copyright © 2005. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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