Patient Characteristics and ICU Mortality Predictors in Severe Community Acquired Pneumonia
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- Category: Vol. 85, March 2017
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Patient Characteristics and ICU Mortality Predictors in Severe Community Acquired Pneumonia, OSAMA M. MOMTAZ, ALY O. ABDUL-AZEEZ and MOHAMED A. TAHA
Abstract
Background: Severe Community-Acquired Pneumonia (CAP) is a potentially life-threatening infection worldwide and frequently requires ICU admission with relatively high mortality.
Objectives: To describe patient's characteristics, mortality rate and etiological pathogens in patients with severe CAP who required ICU admission and to determine the predictors of mortality.
Methods: This prospective study included 95 consecutive patients admitted to the ICU with severe CAP. All patients were subjected to clinical examination, assessment by APACHE II and CURG-65 scoring as well as radiological, laboratory and microbiological examination. Different possible mortality risks were assessed for statistical analysis.
Results: The overall mortality was 44.2%. The most frequently predicted high risk of mortality were requirement for MV, PaO2/FiO2 <250, CURB-65 score >3, multilobar infiltrate in chest X-ray, age >65 years, APACHE II score >20, serum urea >30mg/dL, serum creatinine >1.0mg/dL, shock at admission, polymicrobial identification, current smoking, total leucocyte counts <4 or >11 X 109) and presence of >!two comorbidities. CURB-65 score 2 and presence of no or only one comorbidity on admission showed more favorable outcome. Microbiological identifications were obtained in 58.9% and streptococcus pneumonia and staphylococcus aureus were the most common isolated pathogens.
Conclusion: ICU patients admitted with severe CAP are associated with high mortality. Early identifying mortality predictors is crucial for meticulous follow-up and tailoring more suitable therapeutic planning which may have the po-tential of improving the outcome of critically ill patients with severe CAP.