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A 7-year study of severe hospital-acquired pneumonia requiring ICU admission.
- Source :
- Intensive Care Medicine; Nov2003, Vol. 29 Issue 11, p1981-1988, 8p
- Publication Year :
- 2003
-
Abstract
- <bold>Objective: </bold>To examine the characteristics, prognostic factors, and outcome of patients with severe hospital-acquired pneumonia admitted to the ICU.<bold>Design and Setting: </bold>Prospective observational clinical study in two medical-surgical ICUs with 16 and 20 beds<bold>Patients and Participants: </bold>During a 7-year period all hospitalized patients requiring admission to either ICU for hospital-acquired pneumonia were followed up.<bold>Measurements and Results: </bold>We diagnosed 96 episodes of severe hospital-acquired pneumonia, and in 67 cases a causal diagnosis was made. Most episodes were late-onset pneumonia. Gram-negative micro-organisms were isolated in 51% of episodes diagnosed, and Pseudomonas aeruginosa was the most frequent pathogen isolated (24%). Clearly significant variations happened between hospitals, particularly affecting the incidence of Aspergillus spp. and Legionella pneumophila. Forty-nine patients developed septic shock (51%). Fifty-one patients died (53%). Aspergillosis and pneumonia due to P. aeruginosa were associated with the highest mortality. Septic shock (OR: 14.27) and chronic obstructive pulmonary disease (OR: 6.11) were independently associated with a poor prognosis.<bold>Conclusions: </bold>Patients with severe hospital-acquired pneumonia admitted to the ICU present high mortality. The presence of septic shock and chronic obstructive pulmonary disease in conjunction with specific microorganisms are associated with a poor prognosis. Local epidemiological data combined with a patient-based approach may allow a more accurate therapy decision making. [ABSTRACT FROM AUTHOR]
- Subjects :
- PNEUMONIA
LUNG diseases
DIAGNOSIS
PSEUDOMONAS
HOSPITAL patients
BACTERIAL disease complications
PNEUMONIA diagnosis
PNEUMONIA treatment
ACADEMIC medical centers
APACHE (Disease classification system)
PREVENTION of communicable diseases
COMPARATIVE studies
CROSS infection
HOSPITAL admission & discharge
INTENSIVE care units
LONGITUDINAL method
OBSTRUCTIVE lung diseases
RESEARCH methodology
MEDICAL cooperation
MULTIVARIATE analysis
PATIENTS
PROGNOSIS
RESEARCH
SEPTIC shock
COMORBIDITY
LOGISTIC regression analysis
EVALUATION research
TREATMENT effectiveness
DISEASE incidence
SEVERITY of illness index
HOSPITAL mortality
DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 03424642
- Volume :
- 29
- Issue :
- 11
- Database :
- Complementary Index
- Journal :
- Intensive Care Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 16629634
- Full Text :
- https://doi.org/10.1007/s00134-003-2008-4