Rodrigo Cavallazzi1, Timothy Wiemken2, Forest W Arnold3, Carlos M Luna4, Jose Bordon5, Robert Kelley6, Charles Feldman7, James D Chalmers8, Antoni Torres9, Julio Ramirez10. 1. Division of Pulmonary, Critical Care and Sleep Disorders Medicine, University of Louisville, Louisville, KY, USA. Electronic address: r0cava01@louisville.edu. 2. Division of Infectious Diseases, University of Louisville, Louisville, KY, USA. Electronic address: tim.wiemken@louisville.edu. 3. Division of Infectious Diseases, University of Louisville, Louisville, KY, USA. Electronic address: f.arnold@louisville.edu. 4. Division of Pulmonary Medicine, Department of Medicine, Hospital de Clinicas, Universidad de Buenos Aires, Buenos Aires, Argentina. Electronic address: dr.cm.luna@gmail.com. 5. Section of Infectious Diseases, Department of Medicine, Providence Hospital, Washington, D.C., USA. Electronic address: jbordon@provhosp.org. 6. Division of Infectious Diseases, University of Louisville, Louisville, KY, USA. Electronic address: robert.kelley@louisville.edu. 7. Division of Pulmonology, Department of Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: feldmanc@medicine.wits.ac.za. 8. Tayside Respiratory Research Group, University of Dundee, Dundee, UK. Electronic address: jamesdchalmers@googlemail.com. 9. Department of Pneumology, Institute of Thorax (ICT), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic of Barcelona, University of Barcelona (UB), CIBER de Enfermedades Respiratoria, Spain. Electronic address: atorres@ub.edu. 10. Division of Infectious Diseases, University of Louisville, Louisville, KY, USA. Electronic address: julio.ramirez@louisville.edu.
Abstract
INTRODUCTION: Severe community-acquired pneumonia (CAP) portends a serious prognosis. The temporal trend in outcome of severe CAP is not well established. We evaluated the temporal trends in the outcomes of severe CAP. METHODS: This is a secondary analysis of 800 patients with severe CAP enrolled in the Community-Acquired Pneumonia Organization International Cohort. Severe CAP was defined as CAP requiring admission to the intensive care unit. Only patients admitted to the ICU upon hospital admission were included in this study. We assessed the trend in outcomes of these patients during three time periods: Period I (June 2001 to April 2004), Period II (May 2004 to January 31 2008), and Period III (February 2008 to February 2013). RESULTS: After adjustment for other variables, mortality was higher for patients admitted during Period II compared with Period I (RR: 1.46; 95% CI: 1.002 to 2.14; P value = 0.049), and for Period III compared with Period I (RR: 1.70; 95% CI: 1.15 to 2.50; P value = 0.008). No significant difference in length of stay or time to clinical stability was found among the three periods. CONCLUSION: The mortality of patients with severe CAP increased over time in our study population. This finding has important health policy implications if confirmed by other studies.
INTRODUCTION: Severe community-acquired pneumonia (CAP) portends a serious prognosis. The temporal trend in outcome of severe CAP is not well established. We evaluated the temporal trends in the outcomes of severe CAP. METHODS: This is a secondary analysis of 800 patients with severe CAP enrolled in the Community-Acquired Pneumonia Organization International Cohort. Severe CAP was defined as CAP requiring admission to the intensive care unit. Only patients admitted to the ICU upon hospital admission were included in this study. We assessed the trend in outcomes of these patients during three time periods: Period I (June 2001 to April 2004), Period II (May 2004 to January 31 2008), and Period III (February 2008 to February 2013). RESULTS: After adjustment for other variables, mortality was higher for patients admitted during Period II compared with Period I (RR: 1.46; 95% CI: 1.002 to 2.14; P value = 0.049), and for Period III compared with Period I (RR: 1.70; 95% CI: 1.15 to 2.50; P value = 0.008). No significant difference in length of stay or time to clinical stability was found among the three periods. CONCLUSION: The mortality of patients with severe CAP increased over time in our study population. This finding has important health policy implications if confirmed by other studies.
Authors: Rodrigo Cavallazzi; Stephen Furmanek; Forest W Arnold; Leslie A Beavin; Richard G Wunderink; Michael S Niederman; Julio A Ramirez Journal: Chest Date: 2020-04-13 Impact factor: 10.262
Authors: Yasser Sakr; Ricard Ferrer; Konrad Reinhart; Richard Beale; Andrew Rhodes; Rui Moreno; Jean Francois Timsit; Laurent Brochard; B Taylor Thompson; Ederlon Rezende; Jean Daniel Chiche Journal: Intensive Care Med Date: 2016-02-15 Impact factor: 17.440