Factors affecting treatment success in community-acquired pneumonia

Gündüz, Canan; Taşbakan, Mehmet Sezai; Sayıner, Abdullah; Çilli, Aykut; Kılınç, Oğuz; Coşkun, Ayşın Şakar

doi:10.3906/sag-1502-87

Cited by 6 publications

(7 citation statements)

References 17 publications

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“…Similarly, data from the same database showed that predictors of treatment failure, defined as clinical deterioration or death, were high PSI scores and low PaO 2 / FiO 2 ratios. 39 These findings support previous reports that PSI score is a strong predictor of clinical outcome. 40,41 The major strength of this study is that it has only concentrated in patients with pneumonia.…”

Section: Discussionsupporting

confidence: 90%

Pneumococcal and influenza vaccination status of hospitalized adults with community acquired pneumonia and the effects of vaccination on clinical presentation

Cetinoglu

Uzaslan

Sayıner

et al. 2017

Human Vaccines & Immunotherapeutics

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Section: Discussionsupporting

confidence: 90%

Pneumococcal and influenza vaccination status of hospitalized adults with community acquired pneumonia and the effects of vaccination on clinical presentation

Cetinoglu

Uzaslan

Sayıner

et al. 2017

Human Vaccines & Immunotherapeutics

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“…Although the CURB-65 score may underestimate severity and mortality in the lower scoring patients, especially the elderly [20], in our study, the CURB-65 score was identi ed to be an independent risk factor for CF. In previous literatures, more data showed PSI or APACHE II score was independent factor associated with failure [4,5,21,22]. Patients aged over 65 years old had more underlying comorbidity and poor outcome [10,11,15,23]; meanwhile, data in our study revealed patients in CF group also had more underlying comorbidity than successfully treated patients.…”

Section: Discussionsupporting

confidence: 40%

Disease burden and prognostic factors for clinical failure in elderly community acquired pneumonia patients

Han

Liu

Chen

et al. 2020

Preprint

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Background: The study was to evaluate initial antimicrobial regimen and clinical outcomes and to explore risk factors for clinical failure (CF) in elderly patients with community-acquired pneumonia (CAP).Methods: 3,011 hospitalized elderly patients were enrolled from 13 national teaching hospitals between January 1, 2014 and December 31, 2014 initiated by the CAP-China network. Risk factors for CF were screened by multivariable logistic regression analysis.Results: The incidence of CF in elderly CAP patients was 13.1%. CF patients were older, longer hospital stays and higher treatment costs than clinical success (CS) patients. The CF patients were more prone to present hyperglycemia, hyponatremia, hypoproteinemia, pleural effusion, respiratory failure and cardiovascular events. Inappropriate initial antimicrobial regimens in CF group were significantly higher than CS group. Undertreatment, CURB-65, PH<7.3, PaO2/FiO2 < 200 mmHg, sodium <130 mmol/L, healthcare-associated pneumonia, white blood cells >10000/mm3, pleural effusion and congestive heart failure were independent risk factors for CF in multivariable logistic regression analysis. Male and bronchiectasis were protective factors.Conclusions: Discordant therapy was a cause of CF. Early accurate detection and management of prevention to potential causes is likely to improve clinical outcomes in elderly patients CAP.Trial registration: A Retrospective Study on Hospitalized Patients With Community-acquired Pneumonia in China (CAP-China) (RSCAP-China), NCT02489578. Registered 16 March 2015, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0005E5S&selectaction=Edit&uid=U0000GWC&ts=2&cx=1bnotb

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“…Although the CURB-65 score may underestimate severity and mortality in the lower scoring patients, especially the elderly [ 20 ], in our study, the CURB-65 score was identified to be an independent risk factor for CF. In previous literatures, more data showed PSI or APACHE II score was independent factor associated with failure [ 4 , 5 , 21 , 22 ]. Patients aged over 65 years old had more underlying comorbidity and poor outcome [ 10 , 11 , 15 , 23 ]; meanwhile, data in our study revealed patients in CF group also had more underlying comorbidity than successfully treated patients.…”

Section: Discussionmentioning

confidence: 99%

Disease burden and prognostic factors for clinical failure in elderly community acquired pneumonia patients

et al. 2020

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Background The study was to evaluate initial antimicrobial regimen and clinical outcomes and to explore risk factors for clinical failure (CF) in elderly patients with community-acquired pneumonia (CAP). Methods 3011 hospitalized elderly patients were enrolled from 13 national teaching hospitals between January 1, 2014 and December 31, 2014 initiated by the CAP-China network. Risk factors for CF were screened by multivariable logistic regression analysis. Results The incidence of CF in elderly CAP patients was 13.1%. CF patients were older, longer hospital stays and higher treatment costs than clinical success (CS) patients. The CF patients were more prone to present hyperglycemia, hyponatremia, hypoproteinemia, pleural effusion, respiratory failure and cardiovascular events. Inappropriate initial antimicrobial regimens in CF group were significantly higher than CS group. Undertreatment, CURB-65, PH < 7.3, PaO2/FiO2 < 200 mmHg, sodium < 130 mmol/L, healthcare-associated pneumonia, white blood cells > 10,000/mm3, pleural effusion and congestive heart failure were independent risk factors for CF in multivariable logistic regression analysis. Male and bronchiectasis were protective factors. Conclusions Discordant therapy was a cause of CF. Early accurate detection and management of prevention to potential causes is likely to improve clinical outcomes in elderly patients CAP. Trial registration A Retrospective Study on Hospitalized Patients With Community-acquired Pneumonia in China (CAP-China) (RSCAP-China), NCT02489578. Registered 16 March 2015, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0005E5S&selectaction=Edit&uid=U0000GWC&ts=2&cx=1bnotb

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Factors affecting treatment success in community-acquired pneumonia

Abstract: The risk of treatment failure is high in patients with severe pneumonia and with respiratory failure. Effective treatment and close monitoring are required for these cases.

Cited by 6 publications

References 17 publications

Pneumococcal and influenza vaccination status of hospitalized adults with community acquired pneumonia and the effects of vaccination on clinical presentation

Pneumococcal and influenza vaccination status of hospitalized adults with community acquired pneumonia and the effects of vaccination on clinical presentation

Disease burden and prognostic factors for clinical failure in elderly community acquired pneumonia patients

Disease burden and prognostic factors for clinical failure in elderly community acquired pneumonia patients

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