TY - JOUR T1 - Acute respiratory distress syndrome in patients admitted for community-acquired pneumonia JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P4894 AU - Jorge Moisés AU - Joan Ramón Badia AU - Miquel Ferrer AU - Albert Gabarrus AU - Catia Cilloniz AU - Eva Polverino AU - Jacobo Sellares AU - Rosanel Amaro AU - Antoni Torres Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P4894.abstract N2 - Background: Community-acquired pneumonia (CAP) is a known risk factor for respiratory distress syndrome (ARDS). Aim: To assess the characteristics and outcomes of CAP patients developing ARDS.Methods: We have prospectively collected in a large systematic database all hospital admissions for CAP from 1997 to 2012. In this population, those who met the Berlin 2012 ARDS definition were identified. Risk factors, and differences between patients with and without ARDS were studied.Results: 4831 hospital admission during the study period were included. 139 patients met ARDS definition criteria (2.9%). Severe ARDS in 12.2% of the cases and moderate ARDS in 42.9%.They also had significantly more elevated C-reactive protein (CRP) (22±12vs.18±11 mg/dL p< 0.001) and PSI severity index was higher. and all met ATS criteria for severe CAP.The microbiological diagnosis was higher in patients with ARDS (59 vs 41%, p<0.001) but no differences were found regarding aetiology as S.pneumoniae was the most common isolation. Among ARDS patients 73% required mechanical ventilation and 26% non-invasive ventilation and mortality at 30 days was significantly higher 40/139(29 %)vs.243/4831 (5%), p <0.001. A multivariate analysis disclosed dyspnea at admission (OR 2.44,CI :2,2 -6, 1,p = 0.009) and a CRP ≥ 12 mg /dL (OR 2,59, 1.5 - 4.6 , p = 0.001) as independent factors associated with the development of ARDS. The presence of ARDS increased risk of mortality (OR: 5.9 , CI :3,4 -10,2, p < 0.001)Conclusions: Less than 3% of patients with CAP met the current ARDS definition. This complication is more common in pneumonia with higher severity index and increased CRP. CAP patients had a 6-fold increase in mortality. ER -