[Prognostic factors and outcome of community-acquired pneumonia in hospitalized adult patients].
BACKGROUND
Severity assessment of community-acquired pneumonia (CAP) patients allows the clinician to decide the place of management and guide empirical antimicrobial treatment.


OBJECTIVE
To assess admission prognostic factors and outcome of CAP in immunocompetent adult patients hospitalized in 21 medical centers in Chile.


METHODS
Prospective evaluation of non immunocompromised adults with CAP admitted to 21 Chilean hospitals between July and August, 1999. All patients were assessed on admission and followed until discharge or death.


RESULTS
During the study period, 1,194 patients (aged 68+/-17 years, 573 males) were evaluated. Seventy two percent had an underlying disease (especially chronic cardiovascular, neurological, respiratory diseases and diabetes mellitus), and 90% were treated with beta-lactamic agents (especially a third generation cephalosporin or penicillin). Mean hospital length of stay was 11+/-9 days, 10% were admitted to Intermediate Care or Intensive Care Units (ICU), 6% were mechanically ventilated and in-hospital mortality was 15.7%. Admission prognostic factors associated with hospital mortality were: advanced age, male gender, presence of comorbidity (chronic cardiovascular, renal, neurological and hepatic disease), undernutrition, suspicion of aspiration, altered mental status, low blood pressure, tachypnea, absence of fever, high blood urea nitrogen, multilobar radiographic pulmonary infiltrates, high risk categories from Chilean Respiratory Diseases Society Consensus, admission to Intermediate Care Units or ICU, and mechanical ventilation. In the multivariate analysis, prognostic factors associated with high hospital mortality were: mental confusion, high blood urea nitrogen, multilobar pneumonia, presence of comorbidity and absence of fever on admission.


CONCLUSIONS
These results validate in Chile, findings from foreign studies.
Gil D
Rodrigo
R
Servicio de Medicina, Instituto Nacional del Tórax, José Miguel Infante 717, Santiago, Chile. rodrigo.gil@terra.cl
Undurraga P
Alvaro
A
Saldías P
Fernando
F
Jiménez P
Patricio
P
Barros M
Manuel
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002677:Chile / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
D000900:Anti-Bacterial Agents