Diseño de un índice pronóstico clínico para el manejo de la neumonía del adulto adquirida en la comunidad

Background: Community acquired pneumonia (CAP) severity assessment is crucial. Aim: To develop a practical clinical severity assessment model for stratifying immunocompetent adult patients hospitalized with CAP into different management groups. Patients and methods: During a 24 months period, 455 ad...

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Autores principales:	Saldías P,Fernando, Farías G,Gonzalo, Villarroel D,Luis, Valdivia C,Gonzalo, Mardónez U,José Miguel, Díaz F,Alejandro
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2004
Materias:	Lung diseases Pneumonia bacterial community acquired Prognosis
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000900003
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spelling	oai:scielo:S0034-988720040009000032005-11-22Diseño de un índice pronóstico clínico para el manejo de la neumonía del adulto adquirida en la comunidadSaldías P,FernandoFarías G,GonzaloVillarroel D,LuisValdivia C,GonzaloMardónez U,José MiguelDíaz F,Alejandro Lung diseases Pneumonia bacterial Pneumonia community acquired Prognosis Background: Community acquired pneumonia (CAP) severity assessment is crucial. Aim: To develop a practical clinical severity assessment model for stratifying immunocompetent adult patients hospitalized with CAP into different management groups. Patients and methods: During a 24 months period, 455 adult patients (250 male, mean age 69±19 years old) were evaluated. All the relevant clinical information recorded and they were followed during hospital stay until discharge or death. Mortality until 30 days after admission was determined. Results: The mean hospital length of stay was 9.9±9.4 days and 76% had an underlying disease. In hospital mortality was 7.6% and 10.1% at 30 days follow up. Admission prognostic factors associated with high mortality at 30 days follow up were: advanced age, presence of comorbidity, suspicion of aspiration, duration of symptoms 2 days, altered mental status, absence of cough, fever and chills; low blood pressure, tachypnea, hypoxemia and multilobar radiographic pulmonary infiltrates. A clinical prognostic index derived from a logistic regression analysis including five independent variables associated with mortality (confusion, comorbidity, low systolic blood pressure, temperature <37.5°C and respiratory rate >20/min), enabled patients to be stratified according to increasing risk of mortality: class 1: 0.9%, class 2: 4.9%, class 3: 14.2%, and class 4: 35.6%. Conclusion: A simple clinical severity assessment tool based on confusion, comorbidity, blood pressure, temperature and respiratory rate could be used to stratify patients with CAP into different risk class categories and management groups (Rev Méd Chile 2004; 132: 1037-46)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.132 n.9 20042004-09-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000900003es10.4067/S0034-98872004000900003
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Lung diseases Pneumonia bacterial Pneumonia community acquired Prognosis
spellingShingle	Lung diseases Pneumonia bacterial Pneumonia community acquired Prognosis Saldías P,Fernando Farías G,Gonzalo Villarroel D,Luis Valdivia C,Gonzalo Mardónez U,José Miguel Díaz F,Alejandro Diseño de un índice pronóstico clínico para el manejo de la neumonía del adulto adquirida en la comunidad
description	Background: Community acquired pneumonia (CAP) severity assessment is crucial. Aim: To develop a practical clinical severity assessment model for stratifying immunocompetent adult patients hospitalized with CAP into different management groups. Patients and methods: During a 24 months period, 455 adult patients (250 male, mean age 69±19 years old) were evaluated. All the relevant clinical information recorded and they were followed during hospital stay until discharge or death. Mortality until 30 days after admission was determined. Results: The mean hospital length of stay was 9.9±9.4 days and 76% had an underlying disease. In hospital mortality was 7.6% and 10.1% at 30 days follow up. Admission prognostic factors associated with high mortality at 30 days follow up were: advanced age, presence of comorbidity, suspicion of aspiration, duration of symptoms 2 days, altered mental status, absence of cough, fever and chills; low blood pressure, tachypnea, hypoxemia and multilobar radiographic pulmonary infiltrates. A clinical prognostic index derived from a logistic regression analysis including five independent variables associated with mortality (confusion, comorbidity, low systolic blood pressure, temperature <37.5°C and respiratory rate >20/min), enabled patients to be stratified according to increasing risk of mortality: class 1: 0.9%, class 2: 4.9%, class 3: 14.2%, and class 4: 35.6%. Conclusion: A simple clinical severity assessment tool based on confusion, comorbidity, blood pressure, temperature and respiratory rate could be used to stratify patients with CAP into different risk class categories and management groups (Rev Méd Chile 2004; 132: 1037-46)
author	Saldías P,Fernando Farías G,Gonzalo Villarroel D,Luis Valdivia C,Gonzalo Mardónez U,José Miguel Díaz F,Alejandro
author_facet	Saldías P,Fernando Farías G,Gonzalo Villarroel D,Luis Valdivia C,Gonzalo Mardónez U,José Miguel Díaz F,Alejandro
author_sort	Saldías P,Fernando
title	Diseño de un índice pronóstico clínico para el manejo de la neumonía del adulto adquirida en la comunidad
title_short	Diseño de un índice pronóstico clínico para el manejo de la neumonía del adulto adquirida en la comunidad
title_full	Diseño de un índice pronóstico clínico para el manejo de la neumonía del adulto adquirida en la comunidad
title_fullStr	Diseño de un índice pronóstico clínico para el manejo de la neumonía del adulto adquirida en la comunidad
title_full_unstemmed	Diseño de un índice pronóstico clínico para el manejo de la neumonía del adulto adquirida en la comunidad
title_sort	diseño de un índice pronóstico clínico para el manejo de la neumonía del adulto adquirida en la comunidad
publisher	Sociedad Médica de Santiago
publishDate	2004
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000900003
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Diseño de un índice pronóstico clínico para el manejo de la neumonía del adulto adquirida en la comunidad

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