Predictive factors of mortality in severe community-acquired pneumonia: A model with data on the first 24h of ICU admission

Sirvent, Josep Maria; Torre, Mari C. de la; Lorencio, C.; Taché, A.; Ferri, Cristina; Garcia‐Gil, L. J.; Torres, Antônio

doi:10.1016/j.medin.2013.03.003

Cited by 23 publications

(15 citation statements)

References 35 publications

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“…In the CAPITAL study (9), younger age, treatment with levofloxacin, and the absence of COPD and asthma were identified as significant predictors of symptom resolution in CAP. Finally, in a study on patients with severe CAP, age, CURB-65 score, presence of septic shock, acute respiratory distress syndrome, and acute renal failure during the first 24 h of ICU admission were found to be independent predictors of mortality (10).…”

Section: Discussionmentioning

confidence: 95%

Factors affecting treatment success in community-acquired pneumonia

Gündüz¹,

Taşbakan²,

Sayıner³

et al. 2016

Turk J Med Sci

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Section: Discussionmentioning

confidence: 95%

Factors affecting treatment success in community-acquired pneumonia

Gündüz¹,

Taşbakan²,

Sayıner³

et al. 2016

Turk J Med Sci

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“…Firstly, while first-dose antibiotics would have been administered as soon as sepsis is identified, we are unable to accurately define the time between administration of antibiotics and collection of specimens for microbiological assessment. This may affect the yield [37,40,41]. Secondly, the inherent retrospective nature of this study increases the risk of bias in data collection.…”

Section: Discussionmentioning

confidence: 99%

Impact of microbial Aetiology on mortality in severe community-acquired pneumonia

et al. 2018

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BackgroundThe impact of different classes of microbial pathogens on mortality in severe community-acquired pneumonia is not well elucidated. Previous studies have shown significant variation in the incidence of viral, bacterial and mixed infections, with conflicting risk associations for mortality. We aimed to determine the risk association of microbial aetiologies with hospital mortality in severe CAP, utilising a diagnostic strategy incorporating molecular testing. Our primary hypothesis was that respiratory viruses were important causative pathogens in severe CAP and was associated with increased mortality when present with bacterial pathogens in mixed viral-bacterial co-infections.MethodsA retrospective cohort study from January 2014 to July 2015 was conducted in a tertiary hospital medical intensive care unit in eastern Singapore, which has a tropical climate. All patients diagnosed with severe community-acquired pneumonia were included.ResultsA total of 117 patients were in the study. Microbial pathogens were identified in 84 (71.8%) patients. Mixed viral-bacterial co-infections occurred in 18 (15.4%) of patients. Isolated viral infections were present in 32 patients (27.4%); isolated bacterial infections were detected in 34 patients (29.1%). Hospital mortality occurred in 16 (13.7%) patients. The most common bacteria isolated was Streptococcus pneumoniae and the most common virus isolated was Influenza A. Univariate and multivariate logistic regression showed that serum procalcitonin, APACHE II severity score and mixed viral-bacterial infection were associated with increased risk of hospital mortality. Mixed viral-bacterial co-infections were associated with an adjusted odds ratio of 13.99 (95% CI 1.30–151.05, p = 0.03) for hospital mortality.ConclusionsRespiratory viruses are common organisms isolated in severe community-acquired pneumonia. Mixed viral-bacterial infections may be associated with an increased risk of mortality.

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“…For each patient in the case group, one patient with identical clinical features was selected from the control group. Matching variables were the following: presence of shock at ICU admission, need for mechanical ventilation, immunosuppression, and age (age cutoff : 65 years), 22 as these are the main determinants for mortality in CAP, 23,24 and COPD, given its high prevalence in Western populations and its controversial role in the increase in mortality in SCAP. 25,26 Continuous variables were compared with Student t test for normally distributed variables, or the Mann-Whitney U test for nonnormally distributed variables.…”

Section: Methodsmentioning

confidence: 99%