Predictors of severe sepsis among patients hospitalized for community-acquired pneumonia

Montull, B. ; Menéndez, R. ; Torres, A. ; Reyes, S. ; Méndez, R. ; Zalacaín, R. ; Capelastegui, A. ; Rajas, O. ; Borderías, L. ; Martin-Villasclaras, J. ; Bello, S. (Universidad de Zaragoza) ; Alfageme, I. ; De Castro, F.R. ; Rello, J. ; Molinos, L. ; Ruiz-Manzano, J. ; Aspa, J.

Resumen: Background: Severe sepsis, may be present on hospital arrival in approximately one-third of patients with community-acquired pneumonia (CAP). Objective: To determine the host characteristics and micro-organisms associated with severe sepsis in patients hospitalized with CAP. Results: We performed a prospective multicenter cohort study in 13 Spanish hospital, on 4070 hospitalized CAP patients, 1529 of whom (37.6%) presented with severe sepsis. Severe sepsis CAP was independently associated with older age (>65 years), alcohol abuse (OR, 1.31; 95% CI, 1.07-1.61), chronic obstructive pulmonary disease (COPD) (OR, 1.75; 95% CI, 1.50-2.04) and renal disease (OR, 1.57; 95% CI, 1.21-2.03), whereas prior antibiotic treatment was a protective factor (OR, 0.62; 95% CI, 0.52-0.73). Bacteremia (OR, 1.37; 95% CI, 1.05-1.79), S pneumoniae (OR, 1.59; 95% CI, 1.31-1.95) and mixed microbial etiology (OR, 1.65; 95% CI, 1.10-2.49) were associated with severe sepsis CAP. Conclusions: CAP patients with COPD, renal disease and alcohol abuse, as well as those with CAP due to S pneumonia or mixed micro-organisms are more likely to present to the hospital with severe sepsis.

Idioma: Inglés

DOI: 10.1371/journal.pone.0145929

Año: 2016

Publicado en: PloS one 11, 1 (2016), e0145929 [9 pp]
ISSN: 1932-6203

Factor impacto JCR: 2.806 (2016)

Categ. JCR: MULTIDISCIPLINARY SCIENCES rank: 15 / 63 = 0.238 (2016) - Q1 - T1

Factor impacto SCIMAGO: 1.236 - Agricultural and Biological Sciences (miscellaneous) (Q1) - Medicine (miscellaneous) (Q1) - Biochemistry, Genetics and Molecular Biology (miscellaneous) (Q1)

Tipo y forma: Article (Published version)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)