RT Journal Article
SR Electronic
T1 Early mortality in patients with community-acquired pneumonia: causes and risk factors
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 733
OP 739
DO 10.1183/09031936.00128107
VO 32
IS 3
A1 C. Garcia-Vidal
A1 N. Fernández-Sabé
A1 J. Carratalà
A1 V. Díaz
A1 R. Verdaguer
A1 J. Dorca
A1 F. Manresa
A1 F. Gudiol
YR 2008
UL http://erj.ersjournals.com/content/32/3/733.abstract
AB The first 48 h of evolution of patients with community-acquired pneumonia (CAP) are critical. The aim of the present study was to determine the frequency, causes and factors associated with early mortality in CAP. Nonimmunocompromised adults hospitalised with CAP were prospectively observed from 1995 to 2005. Early deaths, defined as death due to any cause ≤48 h after admission, were compared with all patients who survived >48 h. Furthermore, early deaths were compared with late deaths (patients who died >48 h) and with survivors. Of 2,457 patients, 57 (2.3%) died ≤48 h after admission. 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 bacteraemia and discordant empiric antibiotic therapy. Currently, early mortality is relatively low and is caused by pneumonia-related factors. It occurs mainly among the elderly and in patients presenting with altered mental status, multilobar pneumonia and septic shock. Pneumococcal bacteraemia and discordant antibiotic therapy, mainly due to lack of coverage against Pseudomonas aeruginosa are also significant risk factors.