• C Sabatier, R Peredo, A Villagrá, N Bacelar, D Mariscal, R Ferrer, M Gallego, and J Vallés.
• Centro de Críticos, Hospital de Sabadell, Instituto Universitario Parc Taulí, UAB, CIBER-Enfermedades Respiratorias, España.
• Med Intensiva. 2010 May 1; 34 (4): 237-45.

ObjectiveTo describe the clinical characteristics and outcomes of patients with community-acquired pneumonia (CAP) admitted to the Intensive Care Unit (ICU). To evaluate new ATS/IDSA criteria to identify patients with CAP who required admission to ICU.DesignRetrospective analysis of prospective collected data in a 7-year period (2000-2007).SettingMedical-surgical ICU with 16 beds.PatientsAll patients with severe CAP admitted to the ICU (n=147). PRIMARY ENDPOINTS: Clinical and microbiological characteristics. Prognostic factors. Comparison of patients admitted in the ICU and ATS/IDSA criteria (group 1: > or = 1 major criterion, group 2: > or = 3 minor criteria and group 3: no criterion).InterventionNone.ResultsAdmission to the ICU is required for patients with acute respiratory failure (60.5%) and with septic shock (28.5%). A total of 71.4%, had an identifiable microbial etiology, S. pneumoniae being the most frequently isolated. Mean time to antibiotic therapy was 4.3+/-4.2h, this being adequate in 97.1%. ICU global mortality rate was 32%. Prognostic factors associated with higher mortality were acute renal failure (OR:4.7), mechanical ventilation (OR:3.4), non-identifiable etiology (OR:4.2) and non-S. pneumonia etiology (OR:3.5). Sixty-eight percent of the patients were included in the first group of the ATS/IDSA criteria and 21% in the second group.ConclusionsCAP mortality is still high despite early antibiotic therapy, especially in those patients with a non-S. pneumonia etiology or who require mechanical ventilation. Almost 90% of the ICU admissions were identified by the new criteria from ATS/IDSA.Copyright 2009 Elsevier España, S.L. y SEMICYUC. All rights reserved.

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