Portal de Periódicos da CAPES

Mortality among severe community-acquired pneumonia patients depends on combinations of 2007 IDSA/ATS minor criteria

2015; Elsevier BV; Volume: 38; Linguagem: Inglês

10.1016/j.ijid.2015.07.026

1878-3511

Haiyan Li, Qi Guo, Weidong Song, Yiping Zhou, Ming Li, Xiaoke Chen, Hui Liu, Hong-lin Peng, Hai‐Qiong Yu, Xia Chen, Nian Liu, Zhong‐dong Lü, Li-hua Liang, Qing-zhou Zhao, Mei Jiang,

Nosocomial Infections in ICU

ObjectivesThe individual 2007 Infectious Disease Society of America (IDSA)/American Thoracic Society (ATS) minor criteria for severe community-acquired pneumonia (CAP) are of unequal weight in predicting mortality. It is not clear whether the combinations of predictive findings might imply diverse severities or different mortalities.MethodsA prospective two centre cohort study was performed of 385 severe CAP patients fulfilling three or more IDSA/ATS minor criteria amongst 1430 patients.ResultsHospital mortality rose sharply from 5.7%, 9.9%, and 16.5%, respectively, for patients with none of three predictive findings most strongly associated to mortality (PaO2/FiO2 ≤ 250 mm Hg, confusion and uraemia), one of those, and two of those to 38.6% for patients with all those (p < 0.001). The number of three predictive findings present had a significantly increased odds ratio for mortality of 2.796 (p < 0.001), and had the degree of positive association with sequential organ failure assessment scores at 72 hours, incurring significantly longer hospital stay and higher costs.ConclusionsDifferent combinations of 2007 IDSA/ATS minor criteria for severe CAP were associated to diverse severities and different mortalities. The combination of PaO2/FiO2 ≤ 250 mm Hg, confusion and uraemia predicted more severity and higher mortality compared with others.