Severe community-acquired pneumonia: Characteristics and prognostic factors in ventilated and non-ventilated patients

• DOI: 10.1371/journal.pone.0191721
• Publication Date: 2018-01-25T13:44:35Z
• Authors: Miquel Ferrer; Chiara Travierso; Catia Cilloniz; Albert Gabarrus; Otavio T. Ranzani; Eva Polverino; Adamantia Liapikou; Francesco Blasi; Antoni Torres
• Keywords: Male; Science; Aged; Aged, 80 and over; Community-Acquired Infections; Female; Humans; Male; Middle Aged; Pneumonia; Prognosis; Prospective Studies; Respiration, Artificial; Biochemistry, Genetics and Molecular Biology (all); Agricultural and Biological Sciences (all); Pneumònia; Respiració artificial; 03 medical and health sciences; 0302 clinical medicine; Mortalitat; Humans; Septicèmia; Prospective Studies; Mortality; Aged; Aged, 80 and over; Q; R; Septicemia; Pneumonia; Middle Aged; Prognosis; Respiration, Artificial; 3. Good health; Community-Acquired Infections; Artificial respiration; Medicine; Female; Research Article

Background Patients with severe community-acquired pneumonia (SCAP) and life-threatening acute respiratory failure may require invasive mechanical ventilation (IMV). Since use of IMV is often associated significant morbidity mortality, we assessed whether patients invasively ventilated would represent a target population for interventions aimed at reducing mortality SCAP. Methods We prospectively recruited consecutive SCAP 12 years. the characteristics outcomes presentation pneumonia, compared those without IMV, determined influence risks factors on multivariate weighted logistic regression using propensity score. Results Among 3,719 hospitalized CAP, 664 (18%) had criteria SCAP, 154 (23%) received pneumonia; 198 (30%) presented septic shock. In 370 (56%) cases was diagnosed based solely presence 3 or more IDSA/ATS minor criteria. Streptococcus pneumoniae main pathogen in both groups. The 30-day higher to non-intubated (51, 33%, vs. 94, 18% respectively, p<0·001), than that predicted by APACHE-II score (26%). independently analysis (adjusted odds-ratio 3·54, 95% confidence interval 1·45–8·37, p = 0·006). Other independent predictors were shock, worse hypoxemia increased serum potassium. Conclusion Invasive should be considered different future clinical trials new addressed improve