AI Summary & Key Takeaways
AI InsightThe overall mortality rate was found as 52.1%.
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Abstract
The Role of Clinical Parameters in the Prognosis of Severe Community-acquired Pneumonia Patients with severe community-acquired pneumonia (CAP) who require intensive care unit (ICU) treatment have been reported to have a mortality rate of up to 70%. The aim of the present study was to investigate the effect of some clinical and laboratory indices on the outcome of CAP. A total of 48 patients with severe CAP (24 male, 24 female, mean age 64±18 years) admitted in our respiratory ICU were enrolled in the study. The overall mortality rate was found as 52.1%. Twenty-three patients (47.3%) were on antibiotic treatment before ICU admission and comorbid diseases were present in 38 of 48 patients (79.2%). Pleural effusion was detected in chest X-ray of 17 patients (35.4%) and radiological multilobar involvement of pneumonia was found at 39 of 48 patients (81.2%). The responsible microorganism was isolated in 17 patients (35.4%) and the leading pathogens were found to be Streptococcus pneumoniae and Staphylococcus aureus. The mean APACHE II score was 16.06±5 in our study population. The mortality rates in patients with APACHE II score more or less than 16 were found as 71.4% and 37.0%, respectively (c2=5.60, p=0.018) and in patients whose length of total hospital stay was less or more than 10 days were found as %78.9 and %34.5, respectively (c2=9.09, p=0.003). In patients who required mechanical ventilatory support the mortality rate was %87.5, whereas in patients who did not it was %34.8 (c2=12.06, p=0.001). No other significant differences were found between the outcome of pneumonia and all other investigated parameters.
Özet
Yoğun bakım tedavisi gerektiren ciddi toplum kökenli pnömoni (TKP) olgularında, %70' lere ulaşan mortalite oranları bildirilmektedir. Bu çalışmanın amacı, klinik ve laboratuvar parametrelerin, TKP prognozundaki etkilerini araştırmaktı. Çalışmaya, ciddi TKP tanısı ile yoğun bakım ünitemize (YBÜ) yatırılan 48 hasta (24 erkek, 24 kadın, yaş ortalaması 64±18) alındı. Mortalite oranı %52.1 bulundu. Yirmi üç hasta (%47.3) YBÜ'ye yatmadan önce antibiyotik kullanmaktaydı ve 48 hastanın 38' inde (%79.2) eşlik eden hastalık mevcuttu. Akciğer radyografisinde, 17 hastada (%35.4) plevral effüzyon saptandı ve 48 hastanın 39'unda (%81.2) multilober tutulum vardı. Etken mikroorganizma, 17 hastada (%35.4) izole edildi ve önde gelen patojenler Streptococcus pneumoniae ile Staphylococcus aureus'tu. Çalışma grubunun ortalama APACHE II skoru 16.06±5 idi. Mortalite oranları; APACHE II skoru 16'nın üstünde ve altında olanlarda sırası ile %71.4 ve %37.0 (c2=5.60, p=0.018), hastanede kalış süresi 10 günden kısa ve uzun olanlarda sırası ile %78.9 ve %34.5 (c2=9.09, p=0.003) ve mekanik ventilatör desteğine alınanlarda ve alınmayanlarda sırası ile %87.5 ve %34.8 (c2=12.06, p=0.001) idi. Araştırılan diğer parametreler ve prognoz arasında anlamlı ilişkiler saptanamadı.