作者@article {Singanayagam36 = {Singanayagam,A. and Chalmers, J.D. and Akram, A.R. and Hill, A.T.}, title = {Impact of inhaled corticosteroid use on outcome in COPD patients admitted with pneumonia}, volume = {38}, number = {1}, pages = {36--41}, year = {2011}, doi = {10.1183/09031936.00077010}, publisher = {European Respiratory Society}, abstract = {The aim of this study was to investigate whether inhaled corticosteroid (ICS) use affects outcome in patients with chronic obstructive pulmonary disease (COPD) admitted with community-acquired pneumonia (CAP). This was a prospective, observational study of patients with spirometry-confirmed COPD presenting with a primary diagnosis of CAP in Lothian, UK. Outcome measures were compared between ICS users and non-ICS users. Of 490 patients included in the study, 76.7\% were classified as ICS users. ICS users had higher Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage compared with non-ICS users (mean{\textpm}sd 3.2{\textpm}0.8 versus 2.6{\textpm}0.9; p\<0.0001). There were no significant differences in pneumonia severity (mean{\textpm}sd Pneumonia Severity Index (PSI) 4.2{\textpm}0.8 versus 4.3{\textpm}0.8 (p = 0.3); mean{\textpm}sd CURB-65 score 2.1{\textpm}1.3 versus 2.3{\textpm}1.3 (p = 0.07)) or markers of systemic inflammation (median C-reactive protein 148 (interquartile range 58{\textendash}268) mg{\textperiodcentered}L-1 versus 183 (IQR 85{\textendash}302) mg{\textperiodcentered}L-1; p = 0.08) between ICS users and non-ICS users. On multivariable analysis, after adjustment for COPD severity and PSI, ICS use was not independently associated with 30-day mortality (OR 1.71, 95\% CI 0.75{\textendash}3.90; p = 0.2), 6-month mortality (OR 1.62, 95\% CI 0.82{\textendash}3.16; p = 0.2), requirement for mechanical ventilation and/or inotropic support (OR 0.73, 95\% CI 0.33{\textendash}1.62; p = 0.4) or development of complicated pneumonia (OR 0.71, 95\% CI 0.25{\textendash}1.99; p = 0.5). Prior ICS use had no impact on outcome in patients with COPD admitted with CAP.}, issn = {0903-1936}, URL = {//www.qdcxjkg.com/content/38/1/36}, eprint = {//www.qdcxjkg.com/content/38/1/36.full.pdf}, journal = {European Respiratory Journal} }