Neumonía adquirida en la comunidad en el adulto hospitalizado: Cuadro clínico y factores pronósticos

Background: Community-acquired pneumonia (CAP) is a serious health problem in Chile. Aim: To study prognostic factors on admission and outcome of CAP, in immune competent adult patients, hospitalized in the Catholic University Clinical Hospital. Patients and methods: All adult patients admitted with...

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Autores principales:	Saldías P,Fernando, Mardónez U,José Miguel, Marchesse R,Miguel, Viviani G,Paola, Farías G,Gonzalo, Díaz F,Alejandro
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2002
Materias:	Cephalosporins Hospital mortality Pneumonia, bacterial
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872002001200007
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spelling	oai:scielo:S0034-988720020012000072003-02-05Neumonía adquirida en la comunidad en el adulto hospitalizado: Cuadro clínico y factores pronósticosSaldías P,FernandoMardónez U,José MiguelMarchesse R,MiguelViviani G,PaolaFarías G,GonzaloDíaz F,Alejandro Cephalosporins Hospital mortality Pneumonia, bacterial Background: Community-acquired pneumonia (CAP) is a serious health problem in Chile. Aim: To study prognostic factors on admission and outcome of CAP, in immune competent adult patients, hospitalized in the Catholic University Clinical Hospital. Patients and methods: All adult patients admitted with a CAP in a period of 2 years were prospectively studied. Patients with immunodeficiency, solid tumors or receiving oral adrenal steroids were excluded from the study. Results: In the study period, 463 patients (69±19 years, 55% male) were evaluated. Ninety four percent were treated with 2nd or 3rd generation cephalosporins. Mean hospital length of stay was 10 days. Mortality during hospital stay was 8% and in the ensuing 30 days, it was 12%. Bacterial etiology was established in 25% of cases. The most frequent pathogens isolated were Streptococcus pneumoniae (10.2%), Haemophilus influenzae (3.7%), Staphylococcus aureus (2.8%) and Gram negative bacilli (5.2%). Admission prognostic factors associated with hospital mortality were: an age over 65 years, presence of comorbidity, chronic neurological and hepatic disease, suspicion of aspiration, duration of symptoms for less than 3 days, presence of dyspnea and altered mental status, absence of cough, fever and chills; low blood pressure, tachypnea, metabolic acidosis, hypoxemia, high blood urea nitrogen, hypernatremia, hyperkalemia, hyperphosphatemia, hypoalbuminemia, multilobar radiographic pulmonary infiltrates, bacteremia, high risk categories of the Fine Index (IV and V), and admission to Intermediate Care Unit or ICU. Conclusions: The features of community acquired pneumonia of these patients are similar to those reported abroad (Rev Méd Chile 2002; 130: 1373-82).info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.130 n.12 20022002-12-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872002001200007es10.4067/S0034-98872002001200007
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Cephalosporins Hospital mortality Pneumonia, bacterial
spellingShingle	Cephalosporins Hospital mortality Pneumonia, bacterial Saldías P,Fernando Mardónez U,José Miguel Marchesse R,Miguel Viviani G,Paola Farías G,Gonzalo Díaz F,Alejandro Neumonía adquirida en la comunidad en el adulto hospitalizado: Cuadro clínico y factores pronósticos
description	Background: Community-acquired pneumonia (CAP) is a serious health problem in Chile. Aim: To study prognostic factors on admission and outcome of CAP, in immune competent adult patients, hospitalized in the Catholic University Clinical Hospital. Patients and methods: All adult patients admitted with a CAP in a period of 2 years were prospectively studied. Patients with immunodeficiency, solid tumors or receiving oral adrenal steroids were excluded from the study. Results: In the study period, 463 patients (69±19 years, 55% male) were evaluated. Ninety four percent were treated with 2nd or 3rd generation cephalosporins. Mean hospital length of stay was 10 days. Mortality during hospital stay was 8% and in the ensuing 30 days, it was 12%. Bacterial etiology was established in 25% of cases. The most frequent pathogens isolated were Streptococcus pneumoniae (10.2%), Haemophilus influenzae (3.7%), Staphylococcus aureus (2.8%) and Gram negative bacilli (5.2%). Admission prognostic factors associated with hospital mortality were: an age over 65 years, presence of comorbidity, chronic neurological and hepatic disease, suspicion of aspiration, duration of symptoms for less than 3 days, presence of dyspnea and altered mental status, absence of cough, fever and chills; low blood pressure, tachypnea, metabolic acidosis, hypoxemia, high blood urea nitrogen, hypernatremia, hyperkalemia, hyperphosphatemia, hypoalbuminemia, multilobar radiographic pulmonary infiltrates, bacteremia, high risk categories of the Fine Index (IV and V), and admission to Intermediate Care Unit or ICU. Conclusions: The features of community acquired pneumonia of these patients are similar to those reported abroad (Rev Méd Chile 2002; 130: 1373-82).
author	Saldías P,Fernando Mardónez U,José Miguel Marchesse R,Miguel Viviani G,Paola Farías G,Gonzalo Díaz F,Alejandro
author_facet	Saldías P,Fernando Mardónez U,José Miguel Marchesse R,Miguel Viviani G,Paola Farías G,Gonzalo Díaz F,Alejandro
author_sort	Saldías P,Fernando
title	Neumonía adquirida en la comunidad en el adulto hospitalizado: Cuadro clínico y factores pronósticos
title_short	Neumonía adquirida en la comunidad en el adulto hospitalizado: Cuadro clínico y factores pronósticos
title_full	Neumonía adquirida en la comunidad en el adulto hospitalizado: Cuadro clínico y factores pronósticos
title_fullStr	Neumonía adquirida en la comunidad en el adulto hospitalizado: Cuadro clínico y factores pronósticos
title_full_unstemmed	Neumonía adquirida en la comunidad en el adulto hospitalizado: Cuadro clínico y factores pronósticos
title_sort	neumonía adquirida en la comunidad en el adulto hospitalizado: cuadro clínico y factores pronósticos
publisher	Sociedad Médica de Santiago
publishDate	2002
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872002001200007
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Neumonía adquirida en la comunidad en el adulto hospitalizado: Cuadro clínico y factores pronósticos

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