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A 7-year study of severe hospital-acquired pneumonia requiring ICU admission.
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- Author(s): Vallés, Jordi; Mesalles, Eduard; Mariscal, Dolors; del Mar Fernández, Ma; Peña, Rocío; Jiménez, José Luis; Rello, Jordi; Vallés, Jordi; del Mar Fernández, Ma; Peña, Rocío; Jiménez, José Luis
- Source:
Intensive Care Medicine; Nov2003, Vol. 29 Issue 11, p1981-1988, 8p- Subject Terms:
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 - Source:
- Additional Information
- Subject Terms:
- Abstract:
Objective: To examine the characteristics, prognostic factors, and outcome of patients with severe hospital-acquired pneumonia admitted to the ICU.Design and Setting: Prospective observational clinical study in two medical-surgical ICUs with 16 and 20 bedsPatients and Participants: During a 7-year period all hospitalized patients requiring admission to either ICU for hospital-acquired pneumonia were followed up.Measurements and Results: 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.Conclusions: 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] - Abstract: Copyright of Intensive Care Medicine is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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