title: Factors associated with hospital mortality in community-acquired legionellosis in France.
abstract: The aims of this study were to describe the clinical, biological and radiological features of community-acquired (CA) Legionnaires' disease (LD) and identify the predictors of mortality in hospitalised patients. Demographic data, risk factors, clinical and biological features, medical management, complications, and outcome from 540 hospitalised patients with confirmed CA LD were prospectively recorded. 8.1% of patients (44 out of 540) died. The predictors of survival after Kaplan-Meier analysis were male sex (p = 0.01), age <60 yrs (p = 0.02), general symptoms (p = 0.006), intensive care unit (ICU) stay (p<0.001), and class II-III Pneumonia Severity Index score (p = 0.004). Six predictors of death were identified by multivariate analysis: age (per 10-yr increment) (relative hazard (RH) 1.50, 95% CI 1.21-1.87), female sex (RH 2.00, 95% CI 1.08-3.69), ICU admission (RH 3.31, 95% CI 1.67-6.56), renal failure (RH 2.73, 95% CI 1.42-5.27), corticosteroid therapy (RH 2.54, 95% CI 1.04-6.20) and C-reactive protein (CRP) >500 mg · L(-1) (RH 2.14, 95% CI 1.02-4.48). Appropriate antibiotic therapy was prescribed for 70.8% (292 out of 412) of patients after admission and for 99.8% (537 out of 538) of patients after diagnosis confirmation. In conclusion, female sex, age, ICU stay, renal failure, corticosteroid treatment and increased level of CRP are significant risk factors for mortality in CA LD.
authors: Université de Lyon, F69317 Lyon Cedex 04, France. christian.chidiac@univ-lyon1.fr
authors: C
authors: C
authors: Chidiac
authors: D
authors: D
authors: Che
authors: S
authors: S
authors: Pires-Cronenberger
authors: S
authors: S
authors: Jarraud
authors: C
authors: C
authors: Campèse
authors: A
authors: A
authors: Bissery
authors: P
authors: P
authors: Weinbreck
authors: C
authors: C
authors: Brun-Buisson
authors: J-P
authors: JP
authors: Sollet
authors: R
authors: R
authors: Ecochard
authors: J-C
authors: JC
authors: Desenclos
authors: J
authors: J
authors: Etienne
authors: P
authors: P
authors: Vanhems
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000401:mortality*; D005260:Female; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016952:Legionella pneumophila; D007877:Legionnaires' Disease / Q000188:drug therapy / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents