The first 48 hours of evolution of patients with community-acquired pneumonia (CAP) are critical. The aim of this study was to determine the frequency, causes, and factors associated with early mortality in CAP.
Prospective observational study of non-immunocompromised adults hospitalized with CAP (1995–2005). Early deaths, defined as death due to any cause 48 hours after admission, were compared with all patients who survived >48 hours. Furthermore, early deaths were compared with late deaths (patients who died >48 hours) and with survivors.
Of 2, 457 patients, 57 died 48 hours (2.3%). 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 bacteremia, and discordant empiric antibiotic therapy.
Current early mortality is relatively low and caused by pneumonia-related factors. It occurs mainly among the elderly and patients presenting with altered mental status, multilobar pneumonia, and septic shock. Pneumococcal bacteremia and discordant antibiotic therapy mainly due to lack of coverage against P. aeruginosa are also significant risk factors.
Eur Respir J 2008, doi:10.1183/09031936.00128107
前瞩性观察研究1995–2005年间无免疫抑制的成年住院CAP患者，无论任何原因凡入院后 48h死亡的规定为早期死亡并与生存>48 h的患者比较，此外，将早期死亡与迟发死亡(>48h死亡)及存活者（资料）比较。
作者:admin@医学,生命科学 2011-09-17 06:36