title: Hospital and long-term outcomes of ICU-treated severe community- and hospital-acquired, and ventilator-associated pneumonia patients.
abstract: BACKGROUND
  Our purpose was to analyse the association of pneumonia types with hospital and long-term outcomes of intensive care unit (ICU)-treated pneumonia patients.
  
  
  METHODS
  The occurrence of pneumonia was retrospectively evaluated among prospectively registered patients admitted into a mixed university-level ICU during a 14-month period. Their age, severity of underlying disease, malignancy, immunosuppressive therapy and organ dysfunctions were recorded, as well as the length of hospital stay and short- and long-term mortalities.
  
  
  RESULTS
  There were 117 severe community-acquired pneumonia (SCAP), 66 hospital-acquired pneumonia (HAP) and 25 ventilator-associated pneumonia (VAP) cases among the 817 patients admitted. ICU and hospital mortality did not differ between pneumonia groups. VAP and HAP patients had more malignant underlying diseases than SCAP patients (P < 0.001). HAP patients were older than SCAP and VAP patients (P = 0.023). The admission Acute Physiology and Chronic Health Evaluation II scores did not differ between the groups (P > 0.90). The patients with VAP had higher Sequential Organ Failure Assessment maximum scores compared with patients with SCAP and HAP (P < 0.001). In an adjusted multivariate logistic regression model, there were no significant differences in odds ratios for hospital mortality between the three pneumonia types. Mortality among the hospital survivors during the 12-month follow-up period was 18% (16/89) in the SCAP group, 35% (18/51) in the HAP group and 41% (7/17) in the VAP group (P = 0.023).
  
  
  CONCLUSIONS
  The type of pneumonia (i.e. SCAP, HAP or VAP) had no significant association with hospital mortality, whereas the SCAP patients had the lowest 1-year mortality.
authors.affiliation: Department of Anaesthesiology, Division of Intensive Care, Oulu University Hospital, Finland. jaana.m.karhu@ppshp.fi
authors.forename: J
authors.initials: J
authors.lastname: Karhu
authors.forename: T I
authors.initials: TI
authors.lastname: Ala-Kokko
authors.forename: P
authors.initials: P
authors.lastname: Ylipalosaari
authors.forename: P
authors.initials: P
authors.lastname: Ohtonen
authors.forename: J J
authors.initials: JJ
authors.lastname: Laurila
authors.forename: H
authors.initials: H
authors.lastname: Syrjälä
mesh_terms: D018806:APACHE; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000150:complications / Q000401:mortality / Q000628:therapy*; D003422:Critical Care; D003428:Cross Infection / Q000150:complications / Q000401:mortality / Q000628:therapy*; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018410:Pneumonia, Bacterial / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D053717:Pneumonia, Ventilator-Associated / Q000150:complications / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents