• Journal of critical care · Apr 2019

    Multicenter Study

    Factors associated with mortality in severe community-acquired pneumonia: A multicenter cohort study.

    • Rodolfo Espinoza, Silva José Roberto Lapa E JRLE Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil., Anke Bergmann, Ulisses de Oliveira Melo, Flávio Elias Calil, Robson Correa Santos, and Salluh Jorge I F JIF Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.; Postgraduate Program, Instituto D'Or de.
    • Unidade de Terapia Intensiva, Copa Star Hospital, Rede D'OR São Luiz, Rio de Janeiro, Brazil; Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.. Electronic address: reaespinoza74@gmail.com.
    • J Crit Care. 2019 Apr 1; 50: 82-86.

    ObjectiveDescribe characteristics and outcomes of CAP admitted to public ICUs in Brazil.MethodsRetrospective cohort study in 4 Tertiary Public Hospitals in Rio de Janeiro, Brazil during 2016. Patients admitted to ICUs with a diagnosis of community-acquired pneumonia were included. Clinical and outcomes data were collected from Epimed Monitor System.ResultsFrom 7902 admissions, 802 patients (10, 1%) were included and analyzed. Main source of admission was the emergency department (78, 3%). Median age was 66 (IQR 54-77) years, SAPS3 71(IQR 58-83) and SOFA D1 9(IQR 5-12) points. 67% of patients needed invasive mechanical ventilation, 12% hemodialysis. 47% required vasopressors. ICU and hospital mortality were 55.9% and 66.5% respectively. In a multivariate analysis, malnutrition [OR 2.28(1.21-4.3)], septic shock at admission [OR 1.95(1.39-2.75)], AIDS [3.04(1.16-7.93]), invasive mechanical ventilation [5.07(5.54-7.27)], age > 65 years [2.07(1.48-2.90)] and LOS >1 day before ICU admission [1.90(1.34-2.71)] were associated with increased mortality.ConclusionCAP is associated with high mortality in patients admitted to public ICUs in Brazil. The current findings may help improve resource allocation and should aim at improving access to ICU care since delayed admission was associated with increased hospital mortality.Copyright © 2018 Elsevier Inc. All rights reserved.

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