Kliničke karakteristike pneumonija kod bolesnika sa hroničnom opstruktivnom bolesti pluća

Abstract

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, causing 3.23 million deaths in 2019. The incidence of pneumonia in patients with COPD is almost twice as high as in the general population. Globally, pneumonia is a cause of increased mortality and morbidity rates. A higher incidence of pneumonia and its association with increased mortality and more frequent hospitalizations, which increases the costs of treatment, has been observed in people diagnosed with COPD in comparison to the general population. The aim of this study was to examine the basic clinical features of pneumonia in patients with COPD, as well as to assess the differences in the clinical characteristics of COPD patients in relation to the presence of pneumonia. The study was designed as a case-control study. The study included patients hospitalized and treated at the pneumophysiology department of the Health Center in Kosovska Mitrovica, in the period from January 2017 to December 2019. Data for research purposes were obtained from the patients' medical records. The study included 110 patients with COPD, of which 30 (27.3%) had pneumonia and 80 (72.7%) were not diagnosed with pneumonia. Out of the total number of patients, 65 (59.1%) were males. Patients with pneumonia had statistically significantly lower mean values of leukocytes and neutrophils at admission, and significantly lower hematocrit values at discharge in comparison to patients without pneumonia. COPD patients who had pneumonia were significantly more often treated with antibiotic combination therapy (cephalosporins and fluoroquinolones) and macrolides. Statistically significantly, the most common auscultation findings in patients with COPD and pneumonia included low-pitched and polyphonic wheezes, and complications in the form of effusions and abscesses were also significantly more often registered. In addition to prolonged hospitalization, patients with COPD and pneumonia received significantly lower doses of oxygen compared to COPD patients without pneumonia. Our study shows that pneumonia is highly prevalent and requires long-term hospitalization and treatment, which leads to increased costs, however, it can be cured with adequate treatment, primarily using a combination of several antibiotics.