Community-acquired pneumonia: A 7-years descriptive study. Usefulness of the IDSA/ATS 2007 in the assessment of ICU admission

C. Sabatier, R. Peredo, A. Villagrá, N. Bacelar, D. Mariscal, R. Ferrer, M. Gallego, J. Vallés

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Abstract

Objective: To describe the clinical characteristics and outcomes of patients with community-acquired pneumonia (CAP) admitted to the Intensive Care Unit (ICU). To evaluate new ATS/IDSA criteria to identify patients with CAP who required admission to ICU. Design: Retrospective analysis of prospective collected data in a 7-year period (2000-2007). Setting: Medical-surgical ICU with 16 beds. Patients: All patients with severe CAP admitted to the ICU (n=147). Primary endpoints: Clinical and microbiological characteristics. Prognostic factors. Comparison of patients admitted in the ICU and ATS/IDSA criteria (group 1: ≥1 major criterion, group 2: ≥3 minor criteria and group 3: no criterion). Intervention: None. Results: Admission to the ICU is required for patients with acute respiratory failure (60.5%) and with septic shock (28.5%). A total of 71.4%, had an identifiable microbial etiology, S. pneumoniae being the most frequently isolated. Mean time to antibiotic therapy was 4.3±4.2. h, this being adequate in 97.1%. ICU global mortality rate was 32%. Prognostic factors associated with higher mortality were acute renal failure (OR:4.7), mechanical ventilation (OR:3.4), non-identifiable etiology (OR:4.2) and non-S. pneumonia etiology (OR:3.5). Sixty-eight percent of the patients were included in the first group of the ATS/IDSA criteria and 21% in the second group. Conclusions: CAP mortality is still high despite early antibiotic therapy, especially in those patients with a non-S. pneumonia etiology or who require mechanical ventilation. Almost 90% of the ICU admissions were identified by the new criteria from ATS/IDSA. © 2009 Elsevier España, S.L. y SEMICYUC.
Original languageEnglish
Pages (from-to)237-245
JournalMedicina Intensiva
Volume34
Issue number4
DOIs
Publication statusPublished - 1 Jan 2010

Keywords

  • Community-acquired pneumonia
  • Intensive care unit
  • Prognostic factors

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    Sabatier, C., Peredo, R., Villagrá, A., Bacelar, N., Mariscal, D., Ferrer, R., Gallego, M., & Vallés, J. (2010). Community-acquired pneumonia: A 7-years descriptive study. Usefulness of the IDSA/ATS 2007 in the assessment of ICU admission. Medicina Intensiva, 34(4), 237-245. https://doi.org/10.1016/j.medin.2009.11.008