title: [Prognostic factors in adult patients hospitalized for pneumonia caused by Legionella pneumophila].
abstract: BACKGROUND
  Legionellosis is a multisystem bacterial disease, which causes pneumonia with high mortality in patients with comorbidity and admitted in intensive care units (ICU).
  
  
  OBJECTIVE
  Determine predictors of mortality or ICU admission.
  
  
  METHODS
  Retrospective follow-up of patients diagnosed with Legionella pneumophila pneumonia in Complexo Hospitalario Universitario de A Coruña. Period 2000-2013 (n=240). Analysis of multivariate logistic regression was performed.
  
  
  RESULTS
  Mean age was 57.2±15.4 years old, 88.3% were male. Average score of comorbidity (Charlson score) was 2.3±2.3. There was a clear seasonal variation. Predominant symptoms were fever (92.5%), dry cough (38.1%) and dyspnea (33.9%). Creatinine clearance was lower than 60 mL/min/1.73 m² in 29.7% and sodium<135 mEq/l in 58.3%. Admission to ICU rate was 16.3% and 10.8% needs mechanical ventilation. Inhospital mortality rate was 4.6%, rising to 23.1% in patients admitted to ICU. Variables associated to predict ICU admission were age (OR=0.96), liver disease (OR=7.13), dyspnea (OR=4.33), delirium (OR=5.86) and high levels of lactatedehydrogenase (OR=1.002). Variables associated with inhospital mortality were Charlson index (OR=1.70), mechanical ventilation (OR=31.44) and high levels of lactatedehydrogenase (OR=1.002).
  
  
  CONCLUSIONS
  Younger patients with liver disease, dyspnea and confusion are more likely to be admitted to ICU. Comorbidity, mechanical ventilation and elevated LDH levels are associated with higher mortality rate.
authors.forename: María Virtudes
authors.initials: MV
authors.lastname: Regueiro-Mira
authors.forename: Salvador
authors.initials: S
authors.lastname: Pita-Fernández
authors.forename: Sonia
authors.initials: S
authors.lastname: Pértega-Díaz
authors.forename: Beatriz
authors.initials: B
authors.lastname: López-Calviño
authors.forename: Teresa
authors.initials: T
authors.lastname: Seoane-Pillado
authors.forename: María
authors.initials: M
authors.lastname: Fernández-Albalat-Ruiz
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D003404:Creatinine / Q000378:metabolism; D003693:Delirium / Q000453:epidemiology; D004417:Dyspnea / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007770:L-Lactate Dehydrogenase / Q000097:blood; D016952:Legionella pneumophila; D007877:Legionnaires' Disease / Q000175:diagnosis* / Q000401:mortality; D008107:Liver Diseases / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000382:microbiology* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D012621:Seasons; D013030:Spain / Q000453:epidemiology
chemical_list: D003404:Creatinine; D007770:L-Lactate Dehydrogenase