Rodolfo Espinoza1, José Roberto Lapa E Silva2, Anke Bergmann3, Ulisses de Oliveira Melo4, Flávio Elias Calil5, Robson Correa Santos6, Jorge I F Salluh7. 1. Unidade de Terapia Intensiva, Copa Star Hospital, Rede D'OR São Luiz, Rio de Janeiro, Brazil; Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.. Electronic address: reaespinoza74@gmail.com. 2. Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. 3. Programa de Epidemiologia Clínica. Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil. Electronic address: abergmann@inca.gov.br. 4. Unidade de Terapia Intensiva, Hospital Estadual Alberto Torres, Rio de Janeiro, Brazil; Unidade de Terapia Intensiva, Hospital Estadual Azevedo Lima, Rio de Janeiro, Brazil. 5. Unidade de Terapia Intensiva, Hospital Estadual Getúlio Vargas, Rio de Janeiro, Brazil. Electronic address: calil@openlink.com.br. 6. Unidade de Terapia Intensiva, Hospital Estadual Adão Pereira Nunes, Rio de Janeiro, Brazil. 7. Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.; Postgraduate Program, Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, Brazil.
Abstract
OBJECTIVE: Describe characteristics and outcomes of CAP admitted to public ICUs in Brazil. METHODS: Retrospective cohort study in 4 Tertiary Public Hospitals in Rio de Janeiro, Brazil during 2016. Patients admitted to ICUs with a diagnosis of community-acquired pneumonia were included. Clinical and outcomes data were collected from Epimed Monitor System. RESULTS: From 7902 admissions, 802 patients (10, 1%) were included and analyzed. Main source of admission was the emergency department (78, 3%). Median age was 66 (IQR 54-77) years, SAPS3 71(IQR 58-83) and SOFA D1 9(IQR 5-12) points. 67% of patients needed invasive mechanical ventilation, 12% hemodialysis. 47% required vasopressors. ICU and hospital mortality were 55.9% and 66.5% respectively. In a multivariate analysis, malnutrition [OR 2.28(1.21-4.3)], septic shock at admission [OR 1.95(1.39-2.75)], AIDS [3.04(1.16-7.93]), invasive mechanical ventilation [5.07(5.54-7.27)], age > 65 years [2.07(1.48-2.90)] and LOS >1 day before ICU admission [1.90(1.34-2.71)] were associated with increased mortality. CONCLUSION: CAP is associated with high mortality in patients admitted to public ICUs in Brazil. The current findings may help improve resource allocation and should aim at improving access to ICU care since delayed admission was associated with increased hospital mortality.
OBJECTIVE: Describe characteristics and outcomes of CAP admitted to public ICUs in Brazil. METHODS: Retrospective cohort study in 4 Tertiary Public Hospitals in Rio de Janeiro, Brazil during 2016. Patients admitted to ICUs with a diagnosis of community-acquired pneumonia were included. Clinical and outcomes data were collected from Epimed Monitor System. RESULTS: From 7902 admissions, 802 patients (10, 1%) were included and analyzed. Main source of admission was the emergency department (78, 3%). Median age was 66 (IQR 54-77) years, SAPS3 71(IQR 58-83) and SOFA D1 9(IQR 5-12) points. 67% of patients needed invasive mechanical ventilation, 12% hemodialysis. 47% required vasopressors. ICU and hospital mortality were 55.9% and 66.5% respectively. In a multivariate analysis, malnutrition [OR 2.28(1.21-4.3)], septic shock at admission [OR 1.95(1.39-2.75)], AIDS [3.04(1.16-7.93]), invasive mechanical ventilation [5.07(5.54-7.27)], age > 65 years [2.07(1.48-2.90)] and LOS >1 day before ICU admission [1.90(1.34-2.71)] were associated with increased mortality. CONCLUSION:CAP is associated with high mortality in patients admitted to public ICUs in Brazil. The current findings may help improve resource allocation and should aim at improving access to ICU care since delayed admission was associated with increased hospital mortality.
Authors: Otavio T Ranzani; Leonardo S L Bastos; João Gabriel M Gelli; Janaina F Marchesi; Fernanda Baião; Silvio Hamacher; Fernando A Bozza Journal: Lancet Respir Med Date: 2021-01-15 Impact factor: 30.700
Authors: Rodrigo Jiménez-García; Ana López-de-Andrés; José M de-Miguel-Yanes; Valentín Hernández-Barrera; Javier de-Miguel-Díez; Manuel Méndez-Bailón Journal: Sci Rep Date: 2022-08-24 Impact factor: 4.996