Rates and risk factors associated with hospitalization for pneumonia with ICU admission among adults

Storms, Aaron D.; Chen, Jufu; Jackson, Lisa A.; Nordin, James D.; Naleway, Allison L.; Glanz, Jason M.; Jacobsen, Steven J.; Weintraub, Eric; Klein, Nicola P.; Gargiullo, Paul; Fry, Alicia M.

doi:10.1186/s12890-017-0552-x

Cited by 60 publications

(42 citation statements)

References 21 publications

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“…Severe CAP is frequently complicated by pulmonary and extra-pulmonary complications, including sepsis, septic shock, acute respiratory distress syndrome and acute cardiac events, thus resulting in a significant increase of mortality and need for ICU admission [4,[9][10][11][12][13]. Although there is no general consensus on its definition, the most accepted criteria to address severe CAP are based on the 2007 Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of CAP in adults [1].…”

Section: Aq4mentioning

confidence: 99%

Community-acquired pneumonia as an emergency condition

Cillóniz

Dominedò

García-Vidal

2018

Current Opinion in Critical Care

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Purpose of review Despite the improvements in its management, community-acquired pneumonia (CAP) still exhibits high global morbidity and mortality rates, especially in elderly patients. This review focuses on the most recent findings on the epidemiology, cause, diagnosis and management of CAP. Recent findings There is consistent evidence that the trend in CAP mortality has declined over time. However, the mortality of pneumococcal CAP has not changed in the last two decades, with an increase in the rate of hospitalization and more severe forms of CAP. Streptococcus pneumoniae remains the most frequent cause of CAP in all settings, age groups and regardless of comorbidities. However, the implementation of molecular diagnostic tests in the last years has identified respiratory viruses as a common cause of CAP too. The emergency of multidrug-resistance pathogens is a worldwide concern. An improvement in our ability to promptly identify the causative cause of CAP is required in order to provide pathogen-directed antibiotic therapy, improve antibiotic stewardship programs and implement appropriate vaccine strategies. Summary It is time to apply all the knowledge generated in the last decade in order to optimize the management of CAP.

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Section: Aq4mentioning

confidence: 99%

Community-acquired pneumonia as an emergency condition

Cillóniz

Dominedò

García-Vidal

2018

Current Opinion in Critical Care

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“…Infections are a major threat to frail patients, such as infants, the elderly, immune depressed, oncologic, diabetic, and those who have other major comorbidities 1 2. Cancer patients, in particular, are at a very high risk of developing infections due to malfunctioning of the immune system, a consequence of both the disease itself and its associated therapies 3.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for bloodstream infections in gynecological cancer

Franza

Costantini

Corrado

et al. 2020

Int J Gynecol Cancer

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ObjectiveInfections are a threat to frail patients as they have a higher risk of developing serious complications from bloodstream pathogens. The aim of this study was to determine which factors can predict or diagnose bloodstream infections in patients with an underlying gynecologic malignancy.Materials and MethodsBetween July 2016 and December 2017, 68 patients visiting the emergency room with an underlying gynecologic malignancy were evaluated. Variables concerning underlying disease, invasive procedures, and laboratory and clinical parameters were analyzed. Patients were divided into three groups based on their blood and urine specimens (positive blood specimens, positive urine specimens, and no positive specimens; patients who had both positive blood and urine specimens were included in the group of positive blood specimens). Risk factors for surgical site infections, recent (<30 days) surgery, and chemotherapy were studied separately.Results68 patients were included in the analysis. Mean age was 55.6 years (standard deviation 14.1). 44% of patients had ovarian cancer, 35% cervical cancer, 12% endometrial cancer, and 9% had other cancer types. In total, 96% of all patients had undergone surgery. Patients who had been treated with chemotherapy were at a higher risk of developing bloodstream infection (P=0.04; odds ratio (OR)=7.9). C reactive protein, bilirubin, and oxygen saturation (SO2) were significantly different between patients with an underlying infection and those who had none. Only C reactive protein maintained its significance in a linear model, with a cut-off of 180 mg/L (linear regression, P=0.03; OR=4).ConclusionsChemotherapy is a risk factor for the development of bloodstream infections in patients with an underlying gynecologic malignancy; C reactive protein could be a useful tool in making this diagnosis.

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“…Community acquired pneumonia (CAP) is a leading infectious cause of hospitalizations worldwide accounting for over 1 million inpatient hospitalizations annually in the United States [2,3] . Limited data suggests about 20% of adults hospitalized for pneumonia required an ICU admission which was directly associated with a 50% increase in length of hospital stay [4] . Although less common than pneumonia, ARDS accounts for approximately 10.4% of ICU admissions worldwide with an associated 40% mortality rate depending on severity [5] .…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and treatment of acute pulmonary inflammation in critically ill patients: The role of inflammatory biomarkers

Chalmers¹,

Khawaja²,

Wieruszewski³

et al. 2019

WJCCM

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Pneumonia and acute respiratory distress syndrome are common and important causes of respiratory failure in the intensive care unit with a significant impact on morbidity, mortality and health care utilization despite early antimicrobial therapy and lung protective mechanical ventilation. Both clinical entities are characterized by acute pulmonary inflammation in response to direct or indirect lung injury. Adjunct anti-inflammatory treatment with corticosteroids is increasingly used, although the evidence for benefit is limited. The treatment decisions are based on radiographic, clinical and physiological variables without regards to inflammatory state. Current evidence suggests a role of biomarkers for the assessment of severity, and distinguishing sub-phenotypes (hyperinflammatory versus hypo-inflammatory) with important prognostic and therapeutic implications. Although many inflammatory biomarkers have been studied the most common and of interest are C-reactive protein, procalcitonin, and pro-inflammatory cytokines including interleukin 6. While extensively studied as prognostic tools (prognostic enrichment), limited data are available for the role of biomarkers in determining appropriate initiation, timing and dosing of adjunct anti-inflammatory treatment (predictive enrichment)

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Rates and risk factors associated with hospitalization for pneumonia with ICU admission among adults

Cited by 60 publications

References 21 publications

Community-acquired pneumonia as an emergency condition

Community-acquired pneumonia as an emergency condition

Risk factors for bloodstream infections in gynecological cancer

Diagnosis and treatment of acute pulmonary inflammation in critically ill patients: The role of inflammatory biomarkers

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