Clinical characteristics and prognosis of pneumonia and sepsis: multicenter study

Authors
W.-Y. KIMY.-J. LEES. YEON LIMS. OK KOHW.-I CHOIS. CHAN KIMG. RAK CHONJ. HYEONG KIMJ. YEOL KIMJ. LIMC. KOOK RHEES. PARKH. CHEOL KIMJ. HWA LEEJ. HYUN LEEJ. PARKY. KOHG. YOUNG SUHS.-B. HONG
Department
Dept. of Internal Medicine (내과학)
Issue Date
2013
Citation
Minerva Anestesiologica, Vol.79(12) : 1356-1365, 2013
ISSN
0375-9393
Abstract
Background: Pneumonia is the primary source of sepsis and is significantly associated with mortality. However, only a few studies focus on its clinical characteristics and outcomes. Methods: We evaluated 500 intensive care unit patients who met severe sepsis or septic shock criteria, dividing them into two distinct groups (43%, sepsis with pneumonia; 41%, sepsis with an infection other than pneumonia). Results: Moderate differences between the groups were observed. The group of sepsis with pneumonia had a higher 28-day in-hospital mortality (41% vs. 30%; P=0.02). Multivariate analysis revealed that the presence of pneumonia associated significantly with mortality (OR 1.76, 95% CI 1.11-2.78) along with cardiopulmonary resuscitation (OR 4.20, 95% CI 1.50-11.74), serum lactate ≥3.5 mmol/L (OR 1.92, 95% CI 1.20-3.08), and SOFA score ≥12 (OR 2.41, 95% CI 1.52-3.82). Survival analysis revealed for both groups that the patients with PaO2/FiO2 (PF) ratio <170 and lactate ≥3.5 mmol/L had a worse prognosis than the patients with PF ratio ≥170 and lactate ≥3.5 mmol/L or PF ratio <170 and lactate <3.5 mmol/L. Conclusion: In patients admitted with sepsis, the pneumonia infection independently predicts 28-day in-hospital mortality. Combining the levels of serum lactate and PF ratio could be a useful approach in predicting mortality of these patients. Background: Pneumonia is the primary source of sepsis and is significantly associated with mortality. However, only a few studies focus on its clinical characteristics and outcomes. Methods: We evaluated 500 intensive care unit patients who met severe sepsis or septic shock criteria, dividing them into two distinct groups (43%, sepsis with pneumonia; 41%, sepsis with an infection other than pneumonia). Results: Moderate differences between the groups were observed. The group of sepsis with pneumonia had a higher 28-day in-hospital mortality (41% vs. 30%; P=0.02). Multivariate analysis revealed that the presence of pneumonia associated significantly with mortality (OR 1.76, 95% CI 1.11-2.78) along with cardiopulmonary resuscitation (OR 4.20, 95% CI 1.50-11.74), serum lactate ≥3.5 mmol/L (OR 1.92, 95% CI 1.20-3.08), and SOFA score ≥12 (OR 2.41, 95% CI 1.52-3.82). Survival analysis revealed for both groups that the patients with PaO2/FiO2 (PF) ratio <170 and lactate ≥3.5 mmol/L had a worse prognosis than the patients with PF ratio ≥170 and lactate ≥3.5 mmol/L or PF ratio <170 and lactate <3.5 mmol/L. Conclusion: In patients admitted with sepsis, the pneumonia infection independently predicts 28-day in-hospital mortality. Combining the levels of serum lactate and PF ratio could be a useful approach in predicting mortality of these patients. Key words: Sepsis - Pneumonia - Mortality - Prognosis.
Keywords
SepsisPneumoniaMortalityPrognosis
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/33429
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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