Prognostic factors of non-HIV immunocompromised patients with pulmonary infiltrates.
OBJECTIVE
To assess the outcome and the prognostic factors in 200 non-HIV immunocompromised patients with pulmonary infiltrates (PIs).


METHODS
Prospective observational study.


METHODS
An 800-bed university hospital.


METHODS
Two hundred non-HIV immunocompromised patients (hematologic malignancies, 79 patients; hematopoietic stem cell transplants [HSCTs], 61 patients; and solid-organ transplants, 60 patients).


METHODS
Investigation of prognostic factors related to mortality using a multiple logistic regression model.


RESULTS
Specific diagnosis of the PI was obtained in 78% of the cases (infectious origin was determined in 74%). The overall mortality rate was 39% (78 of 200 patients). Patients with HSCT had the highest mortality rate (53%). A requirement for mechanical ventilation (odds ratio [OR], 28; 95% confidence interval [CI], 9 to 93), an APACHE (acute physiology and chronic health evaluation) II score of > 20 (OR, 5.5; 95% CI, 2 to 14.7), and a delay of > 5 days in establishing a specific diagnosis (OR, 3.4; 95% CI, 1.2 to 9.6) were the variables associated with mortality at the multivariate analysis. The subgroup analysis based on underlying disease confirmed the prognostic significance of these variables and the infectious etiology for the PI.


CONCLUSIONS
Mortality in immunocompromised patients is high, particularly in patients undergoing HSCT. Achieving an earlier diagnosis potentially may improve the mortality rate of these patients.
Rañó
Ana
A
Servei de Pneumologia, Institut Clínic de Pneumología i Cirurgía Toràcica, Barcelona, Spain.
Agustí
Carlos
C
Benito
Natividad
N
Rovira
Montserrat
M
Angrill
Joaquim
J
Pumarola
Tomás
T
Torres
Antoni
A
D018806:APACHE; D000328:Adult; D016001:Confidence Intervals; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D017052:Hospital Mortality; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D016015:Logistic Models; D008171:Lung Diseases / Q000145:classification / Q000175:diagnosis / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012121:Respiration, Artificial