Early Mortality in Patients with Community-Acquired Pneumonia: Causes, and Risk Factors

¹ Infectious Disease
² Microbiology
³ Respiratory Medicine Services, Institut dInvestigació Biomèdica de Bellvitge (IDIBELL) - Hospital Universitari de Bellvitge, University of Barcelona, LHospitalet, Barcelona, Spain

^* To whom correspondence should be addressed. E-mail: carolgv75{at}hotmail.com.

	Abstract

The first 48 hours of evolution of patients with community-acquired pneumonia (CAP) are critical. The aim of this study was to determine the frequency, causes, and factors associated with early mortality in CAP.

Prospective observational study of non-immunocompromised adults hospitalized with CAP (1995–2005). Early deaths, defined as death due to any cause 48 hours after admission, were compared with all patients who survived >48 hours. Furthermore, early deaths were compared with late deaths (patients who died >48 hours) and with survivors.

Of 2, 457 patients, 57 died 48 hours (2.3%). Overall mortality was 7.7%. The main causes of early mortality were respiratory failure and septic shock/multiorgan failure. Independent factors associated with early deaths were increased age, altered mental status at presentation, multilobar pneumonia, shock at admission, pneumococcal bacteremia, and discordant empiric antibiotic therapy.

Current early mortality is relatively low and caused by pneumonia-related factors. It occurs mainly among the elderly and patients presenting with altered mental status, multilobar pneumonia, and septic shock. Pneumococcal bacteremia and discordant antibiotic therapy mainly due to lack of coverage against P. aeruginosa are also significant risk factors.

This article has been cited by other articles:

				R. F. Grossman Community-Acquired Pneumonia: Advances in Management ACCP Pulmonary Med Brd Rev, January 1, 2009; 25(0): 359 - 368. [Full Text] [PDF]