title: Mortality indicators in community-acquired pneumonia requiring intensive care in Turkey.
abstract: BACKGROUND
  Severe community-acquired pneumonia (SCAP) is a fatal disease. This study was conducted to describe an outcome analysis of the intensive care units (ICUs) of Turkey.
  
  
  METHODS
  This study evaluated SCAP cases hospitalized in the ICUs of 19 different hospitals between October 2008 and January 2011. The cases of 413 patients admitted to the ICUs were retrospectively analyzed.
  
  
  RESULTS
  Overall 413 patients were included in the study and 129 (31.2%) died. It was found that bilateral pulmonary involvement (odds ratio (OR) 2.5, 95% confidence interval (CI) 1.1-5.7) and CAP PIRO score (OR 2, 95% CI 1.3-2.9) were independent risk factors for a higher in-ICU mortality, while arterial hypertension (OR 0.3, 95% CI 0.1-0.9) and the application of non-invasive ventilation (OR 0.2, 95% CI 0.1-0.5) decreased mortality. No culture of any kind was obtained for 90 (22%) patients during the entire course of the hospitalization. Blood, bronchoalveolar lavage, and non-bronchoscopic lavage cultures yielded enteric Gram-negatives (n=12), followed by Staphylococcus aureus (n=10), pneumococci (n=6), and Pseudomonas aeruginosa (n=6). For 22% of the patients, none of the culture methods were applied.
  
  
  CONCLUSIONS
  SCAP requiring ICU admission is associated with considerable mortality for ICU patients. Increased awareness appears essential for the microbiological diagnosis of this disease.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, GATA Haydarpasa Training Hospital, Istanbul, Turkey. hakanerdem1969@yahoo.com
authors.forename: Hakan
authors.initials: H
authors.lastname: Erdem
authors.forename: Hulya
authors.initials: H
authors.lastname: Turkan
authors.forename: Aykut
authors.initials: A
authors.lastname: Cilli
authors.forename: Ahmet
authors.initials: A
authors.lastname: Karakas
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Karakurt
authors.forename: Uğur
authors.initials: U
authors.lastname: Bilge
authors.forename: Ozlem
authors.initials: O
authors.lastname: Yazicioglu-Mocin
authors.forename: Nazif
authors.initials: N
authors.lastname: Elaldi
authors.forename: Nalan
authors.initials: N
authors.lastname: Adıguzel
authors.forename: Gokay
authors.initials: G
authors.lastname: Gungor
authors.forename: Canturk
authors.initials: C
authors.lastname: Taşcı
authors.forename: Gulden
authors.initials: G
authors.lastname: Yilmaz
authors.forename: Oral
authors.initials: O
authors.lastname: Oncul
authors.forename: Aygul
authors.initials: A
authors.lastname: Dogan-Celik
authors.forename: Ozcan
authors.initials: O
authors.lastname: Erdemli
authors.forename: Nefise
authors.initials: N
authors.lastname: Oztoprak
authors.forename: Yakup
authors.initials: Y
authors.lastname: Tomak
authors.forename: Asuman
authors.initials: A
authors.lastname: Inan
authors.forename: Burcu
authors.initials: B
authors.lastname: Karaboğa
authors.forename: Demet
authors.initials: D
authors.lastname: Tok
authors.forename: Sibel
authors.initials: S
authors.lastname: Temur
authors.forename: Hafize
authors.initials: H
authors.lastname: Oksuz
authors.forename: Ozgur
authors.initials: O
authors.lastname: Senturk
authors.forename: Unase
authors.initials: U
authors.lastname: Buyukkocak
authors.forename: Fatma
authors.initials: F
authors.lastname: Yilmaz-Karadag
authors.forename: Dilek
authors.initials: D
authors.lastname: Ozcengiz
authors.forename: Turker
authors.initials: T
authors.lastname: Turker
authors.forename: Murat
authors.initials: M
authors.lastname: Afyon
authors.forename: Anil Aktas
authors.initials: AA
authors.lastname: Samur
authors.forename: Asim
authors.initials: A
authors.lastname: Ulcay
authors.forename: Umit
authors.initials: U
authors.lastname: Savasci
authors.forename: Husrev
authors.initials: H
authors.lastname: Diktas
authors.forename: Aylin
authors.initials: A
authors.lastname: Ozgen-Alpaydın
authors.forename: Erol
authors.initials: E
authors.lastname: Kilic
authors.forename: Hayati
authors.initials: H
authors.lastname: Bilgic
authors.forename: Hakan
authors.initials: H
authors.lastname: Leblebicioglu
authors.forename: Serhat
authors.initials: S
authors.lastname: Unal
authors.forename: Guner
authors.initials: G
authors.lastname: Sonmez
authors.forename: Levent
authors.initials: L
authors.lastname: Gorenek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000382:microbiology / Q000401:mortality*; D003422:Critical Care; D003428:Cross Infection / Q000382:microbiology / Q000401:mortality; D003430:Cross-Sectional Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D063868:Patient Outcome Assessment; D011014:Pneumonia / Q000382:microbiology / Q000401:mortality*; D012189:Retrospective Studies; D014421:Turkey; D055815:Young Adult
keywords: CAP; Community-acquired pneumonia; ICU; Intensive care unit; Outcome