PURPOSE: Hospitalizations for chronic obstructive pulmonary disease (COPD) exacerbations are major events in the natural history of the disease in terms of survival, quality of life and risk of further episodes of exacerbation. Acute respiratory infection is a major cause of acute exacerbation of COPD and the secondary pneumonia is a major cause of hospitalization in the patients. Because of the increased aging population in COPD, the number of hospitalizations for health care-associated pneumonia (HCAP) is expected to increase in these days. However, the effects of HCAP on the hospitalization of COPD have not been fully examined.
METHODS: We examined the past three year's records of COPD hospitalization. We analyze the cause of admission, and the incidence of HCAP and community-acquired pneumonia (CAP) in the hospitalized patients. Further, the incidences of HCAP and CAP were compared between COPD patients with or without chronic respiratory failure (CRF) .
RESULTS: The approximately 70 % of the COPD patients were hospitalized due to pneumonia.More than 30% of the hospitalization of COPD was caused by HCAP.The incidence of HCAP was considerably greater than in COPD patients with CRF than in the patients without CRF. Two major contributing factors for HCAP hospitalization were the previous admission for 2 or more days in the 90 days before pneumonia and residency in a nursing home or a long-term care facility.
CONCLUSION: The roles of health care-associated pneumonia (HCAP) on the hospitalization of COPD patients were increased. The HCAP effects on the hospitalization are dominant in COPD patients with chronic respiratory failure.
CLINICAL IMPLICATIONS: The HCAP prevention may be an important strategy for the reduction of the incidence of hospitalization of COPD patients, in particular, with chronic respiratory failure.
DISCLOSURE: Shinji Teramoto, No Financial Disclosure Information; No Product/Research Disclosure Information