Predictors of severe sepsis among patients hospitalized for community-acquired pneumonia

Background Severe sepsis, may be present on hospital arrival in approximately one-third of patients with community-acquired pneumonia (CAP). Objective To determine the host characteristics and micro-organisms associated with severe sepsis in patients hospitalized with CAP. Results We performed a pro...

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Detalles Bibliográficos
Autores: Montull, Beatriz, Menéndez, Rosario, Torres Martí, Antoni, Reyes, Soledad, Méndez, Raúl, Zalacaín, Rafael, Capelastegui, Alberto, Rajas, Olga, Borderías, Luis, Martín Villasclaras, Juan, Bello, Salvador, Alfageme, Inmaculada, Rodríguez de Castro, Felipe, Rello Condomines, Jordi, Molinos, Luis, Ruiz Manzano, Juan
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2016
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/105203
Acceso en línea:https://hdl.handle.net/2445/105203
Access Level:acceso abierto
Palabra clave:Septicèmia
Malalties pulmonars obstructives cròniques
Pneumònia
Antibiòtics
Septicemia
Chronic obstructive pulmonary diseases
Pneumonia
Antibiotics
Descripción
Sumario:Background Severe sepsis, may be present on hospital arrival in approximately one-third of patients with community-acquired pneumonia (CAP). Objective To determine the host characteristics and micro-organisms associated with severe sepsis in patients hospitalized with CAP. Results We performed a prospective multicenter cohort study in 13 Spanish hospital, on 4070 hospi- talized CAP patients, 1529 of whom (37.6%) presented with severe sepsis. Severe sepsis CAP was independently associated with older age ( > 65 years), alcohol abuse (OR, 1.31; 95% CI, 1.07 - 1.61), chronic obstructive pulmonary disease (COPD) (OR, 1.75; 95% CI, 1.50 - 2.04) and renal disease (OR, 1.57; 95% CI, 1.21 - 2.03), whereas prior antibiotic treat- ment was a protective factor (OR, 0.62; 95% CI, 0.52 - 0.73). Bacteremia (OR, 1.37; 95% CI, 1.05 - 1.79), S pneumoniae (OR, 1.59; 95% CI, 1.31 - 1.95) and mixed microbial etiology (OR, 1.65; 95% CI, 1.10 - 2.49) were associated with severe sepsis CAP. Conclusions CAP patients with COPD, renal disease and alcohol abuse, as well as those with CAP due to S pneumonia or mixed micro-organisms are more likely to present to the hospital with severe sepsis.

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