[Community-acquired pneumonia: a 7-years descriptive study. Usefulness of the IDSA/ATS 2007 in the assessment of ICU admission].
OBJECTIVE
To describe the clinical characteristics and outcomes of patients with community-acquired pneumonia (CAP) admitted to the Intensive Care Unit (ICU). To evaluate new ATS/IDSA criteria to identify patients with CAP who required admission to ICU.


METHODS
Retrospective analysis of prospective collected data in a 7-year period (2000-2007).


METHODS
Medical-surgical ICU with 16 beds.


METHODS
All patients with severe CAP admitted to the ICU (n=147). PRIMARY ENDPOINTS: Clinical and microbiological characteristics. Prognostic factors. Comparison of patients admitted in the ICU and ATS/IDSA criteria (group 1: > or = 1 major criterion, group 2: > or = 3 minor criteria and group 3: no criterion).


METHODS
None.


RESULTS
Admission to the ICU is required for patients with acute respiratory failure (60.5%) and with septic shock (28.5%). A total of 71.4%, had an identifiable microbial etiology, S. pneumoniae being the most frequently isolated. Mean time to antibiotic therapy was 4.3+/-4.2h, this being adequate in 97.1%. ICU global mortality rate was 32%. Prognostic factors associated with higher mortality were acute renal failure (OR:4.7), mechanical ventilation (OR:3.4), non-identifiable etiology (OR:4.2) and non-S. pneumonia etiology (OR:3.5). Sixty-eight percent of the patients were included in the first group of the ATS/IDSA criteria and 21% in the second group.


CONCLUSIONS
CAP mortality is still high despite early antibiotic therapy, especially in those patients with a non-S. pneumonia etiology or who require mechanical ventilation. Almost 90% of the ICU admissions were identified by the new criteria from ATS/IDSA.
Sabatier
C
C
Centro de Críticos, Hospital de Sabadell, Instituto Universitario Parc Taulí, UAB, CIBER-Enfermedades Respiratorias, España.
Peredo
R
R
Villagrá
A
A
Bacelar
N
N
Mariscal
D
D
Ferrer
R
R
Gallego
M
M
Vallés
J
J
D017714:Community-Acquired Infections / Q000175:diagnosis; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D018410:Pneumonia, Bacterial / Q000175:diagnosis*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors