Factors impacting on length of stay and mortality of community-acquired pneumonia
Factors impacting on length of stay and mortality of community-acquired pneumonia
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DOI：
10.1111/j.1469-0691.2007.01915.x
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发表时间：
2008-04-01
影响因子：
14.2
通讯作者：
Dal-Re, R.
中科院分区：
文献类型：
--
作者：
Garau, J.;Baquero, F.;Dal-Re, R.
一项为期1年的回顾性多中心研究，以确定影响住院时间（LOS）和死亡率的患者（n = 3233），因为社区获得性肺炎（CAP）入院的因素。肺炎严重程度指数（PSI）高风险等级（IV和V）、血培养阳性、入住重症监护室（ICU）、多肺叶受累和饮酒与LOS延长独立相关。吸烟与LOS降低有关。中心之间的LOS差异显著。只有PSI高风险等级、入住ICU和多叶受累与早期、晚期和总体死亡率相关。血培养阳性、根据治疗指南进行抗菌治疗和建立病因学诊断与晚期和全球死亡率降低有关。这些数据表明，与CAP相关的早期死亡率高度依赖于患者的临床表现。相反，晚期死亡率似乎与临床管理因素更密切相关;因此，病因诊断和遵守适当的治疗指南对结局有显着影响。
A 1-year retrospective multicentre study was performed to identify factors influencing hospital length of stay (LOS) and mortality of patients (n = 3233) admitted to hospital because of community-acquired pneumonia (CAP). Pneumonia severity index (PSI) high-risk classes (IV and V), positive blood culture, admission to an intensive care unit (ICU), multi-lobar involvement and alcohol consumption were associated independently with prolonged LOS. Tobacco smoking was associated with a reduced LOS. The LOS varied markedly among centres. Only PSI high-risk class, admission to ICU and multi-lobar involvement were associated with early, late and global mortality. Positive blood cultures, antimicrobial therapy according to treatment guidelines and the establishment of an aetiological diagnosis were linked to reduced late and global mortality. These data suggest that early mortality associated with CAP is highly dependent on the clinical status of the patient at presentation. Conversely, late mortality seems to be associated more closely with clinical management factors; hence, an aetiological diagnosis and compliance with appropriate therapeutic guidelines have a significant influence on outcome.