Journal Article

Predictors of Severe Sepsis among Patients Hospitalized for Community-Acquired Pneumonia

Borderías, Luis, Martin-Villasclaras, Juan, Molinos, Luis, Bello, Salvador, Torres, Antoni, Montull, Beatriz, Capelastegui, Alberto, Ruiz-Manzano, Juan, Reyes, Soledad, Rello, Jordi, Méndez, Raúl, Zalacaín, Rafael, Menéndez, Rosario, Alfageme, Inmaculada, Rodríguez de Castro, Felipe, Rajas, Olga

2016

Overview

Severe sepsis, may be present on hospital arrival in approximately one-third of patients with community-acquired pneumonia (CAP). To determine the host characteristics and micro-organisms associated with severe sepsis in patients hospitalized with CAP. 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. 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.

• Publisher: Endeavor Business Media,Public Library of Science,Public Library of Science (PLoS)
• Subject: Abuse / Aged / Alcohol / Alcohol abuse / Alcohols / Analysis / Antibiotics / Antigens / Bacteremia / Care and treatment / Chronic obstructive pulmonary disease / Communities / Community-Acquired Infections - complications / Community-Acquired Infections - microbiology / Diagnosis / Drug abuse / Etiology / Female / Health aspects / Hospital patients / Hospitals / Humans / Legionella / Length of Stay / Lung diseases / Male / Microorganisms / Middle Aged / Obstructive lung disease / Patients / Pneumonia / Pneumonia, Bacterial - complications / Pneumonia, Bacterial - microbiology / Pneumonia, Viral - complications / Pneumonia, Viral - virology / Prospective Studies / Risk Factors / Sepsis / Sepsis - epidemiology / Sepsis - etiology / Sepsis - mortality / Severity of Illness Index / Studies