[Prognosis of severe community-acquired pneumonia in alcoholic patients hospitalized in intensive care].
BACKGROUND
The purpose of our study was to determine prognosis factors of alcoholic patients hospitalised in an intensive care unit with severe community-acquired pneumonia (SCAP).


METHODS
Chronic alcoholism was defined by intake of pur alcohol more than 36 g per day for more than one year and severe community-acquired pneumonia by the criteria of the American Thoracic Society.


RESULTS
50 patients were included. Mortality rate was 48% in the department and 68% at two months after dismissal from intensive care. 1 Yen percent of patients were admitted in a state of shock (100% mortality). The most frequent pathogen was Streptococus pneumoniae (38%). The major complications were: 24% acute respiratory distress syndrome (ARDS), 18% multi-organ failure, 48% disseminated intravascular coagulopathy (DIC), 48% pulmonary superinfection. Antibiotherapy was not conform to current guidelines in 20% of cases and hence led to 90% death.


CONCLUSIONS
Mortality rate was higher than in other studies. Bad prognosis factors were identified: severe state on admission, shock on admission or subsequently, non adapted initial antibiotherapy, Child's score B and C, Streptococus pneumoniae, complications: ARDS, superinfections, coagulopathy, multi organ failure.
D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000150:complications / Q000401:mortality / Q000628:therapy; D004211:Disseminated Intravascular Coagulation / Q000150:complications; D006801:Humans; D007362:Intensive Care Units; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000150:complications; D011008:Pneumococcal Infections / Q000150:complications / Q000401:mortality / Q000628:therapy; D011014:Pneumonia / Q000150:complications / Q000401:mortality* / Q000628:therapy; D011379:Prognosis; D012128:Respiratory Distress Syndrome / Q000150:complications; D013997:Time Factors
D000900:Anti-Bacterial Agents
Pronostic des pneumopathies communautaires graves chez des patients éthyliques chroniques hospitalisés en réanimation.