Impact of chronic obstructive pulmonary disease on mortality in community acquired pneumonia: a meta-analysis.

Background:The aim of the present study was to systematically review the exiting literature and to proceed a meta-analysis to determine the impact of chronic obstructive pulmonary disease (COPD) on mortality in patients with community acquired pneumonia.Materials & methods:Eligible studies were searched from PubMed, Cochrane Library and EMBASE. Odds ratios (ORs) with 95% CIs were used as effect estimates.Results:Twenty cohort studies were included. Analysis of unadjusted data revealed nonsignificant short- and long-term mortality associated with COPD. Analysis of adjusted 30-days mortality showed similarly no association between COPD and increased 30-days mortality (OR: 1.06, [0.68, 1.44]) but a positive association when COPD was confirmed spirometrically (OR: 1.84, [1.06, 2.62]).Conclusion:There is still no evidence to clear the impact of COPD on mortality in patients with community acquired pneumonia. More prospective studies with spirometrically-defined COPD and adequate adjustment for confounders are needed.