[Prognostic factors in community acquired pneumonia. Prospective multicenter study in internal medical departments].
OBJECTIVE
the aims of the present study were to evaluate the clinical and microbiological characteristics of patients suffering from community-acquired pneumonia attended in the Internal Medical Departments of several Spanish institutions and to analyze those prognostic factors predicting thirty-day mortality in such patients.


METHODS
Past medical history, symptoms and signs, radiological pattern and blood parameters including albumin and C Reactive Protein, were recorded for each patient. Time from admission to starting antibiotics (in hours) and follow-up (in days) were also recorded. Patients were stratified by the Pneumonia Severity Index in five risk classes.


RESULTS
389 patients were included in the study, most of them in Fine categories III to V. Mortality rate for all patients was 12.1% (48 patients), increasing up to 40% in Fine Class V. Neither age, sex nor time from admission to the start of antibiotic treatment predicted survival rates. Plasmatic levels of PCR or microbiologic diagnosis were not related to clinical outcome. In the Cox regression analysis, oriented patients (OR 0.138, IC95% 0.055-0.324), and those with normal albuminemia (OR 0.207, IC95% 0.103-0.417) showed better survival rates. On the contrary, those with active carcinoma (OR 3.2, IC95% 1.181-8.947) significantly showed a reduced life expectancy.


CONCLUSIONS
Besides the fully accepted Fine scale criteria, albumin measurements should be included in routine evaluation in order to improve patient s prognostic classification.
Apolinario Hidalgo
R
R
Servicio de Medicina Interna, Hospital Universitario Insular de Gran Canaria. rapohid@gobiernodecanarias.org
Suárez Cabrera
M
M
Geijo Martínez
M P
MP
Bernabéu-Wittel
M
M
Falguera Sacrest
M
M
Limiñana Cañal
J M
JM
D000368:Aged; D017714:Community-Acquired Infections / Q000150:complications / Q000401:mortality; D005260:Female; D006748:Hospital Departments; D006801:Humans; D007388:Internal Medicine; D008297:Male; D011014:Pneumonia / Q000150:complications / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies