Pseudomonas aeruginosa in sputum at admission in hospitalised patients for acute COPD exacerbation: prognostic implications
Abstract number: O31
Salvadó M., Garcia Vidal C., Monzón H., Rodriguez-Carballeira M., Cuchi E., Heredia J.L., Garau J., Almagro P.
Background:Pseudomonas aeruginosa (PA) isolation in sputum in hospitalised patients for acute COPD exacerbation has been associated with an advanced stage of the pulmonary disease. However, information regarding the relation between PA isolation and mortality is lacking. The aim of this study was to analyse the relation between PA isolation in patients hospitalised for COPD exacerbation and long-term mortality.
Methods: We prospectively recorded clinical information and sputum cultures of all COPD patients with an acute exacerbation that were admitted to our hospital between June 2003 and September 2004. All readmissions during the following year were recorded. Mortality was assessed on January 2007 and Kaplan-Meyer analysis was made.
Results: 188 patients with a mean of age 72 years (SD 11) were included. Ninety five (50.5%) patients were classified as severe disease and 26 patients (13.8%) as very severe disease following Gold criteria. Among this cohort, a total of 469 episodes of hospital admission due to COPD exacerbation were recorded. Valid sputum was collected in 220 episodes, 49% of these had mouth flora. The prevalence of PA isolation was 23.2% of all episodes, becoming the most frequently isolated species. H. influenzae (11%) and S. pneumoniae (10%) remained a common aetiology. Overall mortality at 3 years was 61.3% in patients with PA isolation versus 37.2% in patients without PA isolation (OR 2.18; CI 95% 1.283.71; p = 0.004). After adjustment for age and FEV1, the relation between PA isolation and mortality remained significant.
Conclusion: PA isolation in sputum in hospitalised patients for acute COPD exacerbation is a marker of high 3-year mortality, independently of respiratory function and age.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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