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Minerva anestesiologica · Dec 2013
Multicenter StudyClinical characteristics and prognosis of pneumonia and sepsis: multicenter study.
- W Y Kim, Y J Lee, S Yeon Lim, S Ok Koh, W I Choi, S Chan Kim, G Rak Chon, J Hyeong Kim, J Yeol Kim, J Lim, C Kook Rhee, S Park, H Cheol Kim, J Hwa Lee, J Hyun Lee, J Park, Y Koh, G Young Suh, and S B Hong.... more
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea - Kim W.-Y. 1, Lee Y.-J. 2, Yeon Lim S. 3, Ok Koh S. 4, Choi W.-I.... more
- Minerva Anestesiol. 2013 Dec 1;79(12):1356-65.
BackgroundPneumonia is the primary source of sepsis and is significantly associated with mortality. However, only a few studies focus on its clinical characteristics and outcomes.MethodsWe evaluated 500 intensive care unit patients who met severe sepsis or septic shock criteria, dividing them into two distinct groups (43%, sepsis with pneumonia; 41%, sepsis with an infection other than pneumonia).ResultsModerate differences between the groups were observed. The group of sepsis with pneumonia had a higher 28-day in-hospital mortality (41% vs. 30%; P=0.02). Multivariate analysis revealed that the presence of pneumonia associated significantly with mortality (OR 1.76, 95% CI 1.11-2.78) along with cardiopulmonary resuscitation (OR 4.20, 95% CI 1.50-11.74), serum lactate ≥ 3.5 mmol/L (OR 1.92, 95% CI 1.20-3.08), and SOFA score ≥ 12 (OR 2.41, 95% CI 1.52-3.82). Survival analysis revealed for both groups that the patients with PaO2/FiO2 (PF) ratio <170 and lactate ≥ 3.5 mmol/L had a worse prognosis than the patients with PF ratio ≥ 170 and lactate ≥ 3.5 mmol/L or PF ratio <170 and lactate <3.5 mmol/L.ConclusionIn patients admitted with sepsis, the pneumonia infection independently predicts 28-day in-hospital mortality. Combining the levels of serum lactate and PF ratio could be a useful approach in predicting mortality of these patients.
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