RT Journal Article
SR Electronic
T1 Factors associated with hospital mortality in community-acquired legionellosis in France
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 963
OP 970
DO 10.1183/09031936.00076911
VO 39
IS 4
A1 C. Chidiac
A1 D. Che
A1 S. Pires-Cronenberger
A1 S. Jarraud
A1 C. Campèse
A1 A. Bissery
A1 P. Weinbreck
A1 C. Brun-Buisson
A1 J-P. Sollet
A1 R. Ecochard
A1 J-C. Desenclos
A1 J. Etienne
A1 P. Vanhems
A1 the French Legionnaires’ Disease Study Group
YR 2012
UL http://erj.ersjournals.com/content/39/4/963.abstract
AB The aims of this study were to describe the clinical, biological and radiological features of community-acquired (CA) Legionnaires’ disease (LD) and identify the predictors of mortality in hospitalised patients. Demographic data, risk factors, clinical and biological features, medical management, complications, and outcome from 540 hospitalised patients with confirmed CA LD were prospectively recorded. 8.1% of patients (44 out of 540) died. The predictors of survival after Kaplan–Meier analysis were male sex (p=0.01), age <60 yrs (p=0.02), general symptoms (p=0.006), intensive care unit (ICU) stay (p<0.001), and class II–III Pneumonia Severity Index score (p=0.004). Six predictors of death were identified by multivariate analysis: age (per 10-yr increment) (relative hazard (RH) 1.50, 95% CI 1.21–1.87), female sex (RH 2.00, 95% CI 1.08–3.69), ICU admission (RH 3.31, 95% CI 1.67–6.56), renal failure (RH 2.73, 95% CI 1.42–5.27), corticosteroid therapy (RH 2.54, 95% CI 1.04–6.20) and C-reactive protein (CRP) >500 mg·L−1 (RH 2.14, 95% CI 1.02–4.48). Appropriate antibiotic therapy was prescribed for 70.8% (292 out of 412) of patients after admission and for 99.8% (537 out of 538) of patients after diagnosis confirmation. In conclusion, female sex, age, ICU stay, renal failure, corticosteroid treatment and increased level of CRP are significant risk factors for mortality in CA LD.