title: Severe community-acquired pneumonia: factors influencing need of intensive care treatment and prognosis.
abstract: 53 patients with community-acquired pneumonia requiring treatment in an Intensive Care Unit (ICU) were studied retrospectively. The majority of patients (77%) had some predisposing factor: illness, smoking or alcoholism. A cause of pneumonia was established in 53% of the cases; Streptococcus pneumoniae was the dominating pathogen. Immediate active treatment was required in 70% of the patients and 58% were treated with mechanical ventilation. The overall mortality was 25% (32% among patients treated with mechanical ventilation) and rose to 39% when a follow-up period of 3.25 years on average was included. A significantly higher mortality rate was seen among elderly patients and among those who were previously immunocompromised or who had a leukocyte count of less than or equal to 9 X 10(9)/l on admission to hospital. It is concluded that although the mortality rate was considerable among the 53 ICU-treated patients with severe community-acquired pneumonias, several were saved by intensive care treatment. Most of those who survived their pneumonia eventually recovered fully.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001469:Barotrauma / Q000209:etiology; D001772:Blood Cell Count; D001799:Blood Sedimentation; D003428:Cross Infection / Q000209:etiology; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007108:Immune Tolerance; D007275:Injections, Intravenous; D007362:Intensive Care Units; D007902:Length of Stay; D055370:Lung Injury; D008297:Male; D008478:Mediastinal Emphysema / Q000209:etiology; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000635:transmission*; D011030:Pneumothorax / Q000209:etiology; D011379:Prognosis; D011655:Pulmonary Embolism / Q000209:etiology; D012189:Retrospective Studies; D012907:Smoking
chemical_list: D000900:Anti-Bacterial Agents; D003907:Dexamethasone; D008775:Methylprednisolone