Clinical Aspects and Prognostic Factors of Severe Pneumonia / 中华医院感染学杂志

ABSTRACT

OBJECTIVE To conclude and analyze epidemiology,etiology,diagnostic,treatment and prognostic factors of local adult hospitalized patients with severe pneumonia.METHODS A retrospective analysis with case-control study was designed.All the medical records of consecutive patients aged ≥18 yrs with diagnosis of pneumonia from Sep 2000 to Sep 2005 in the First Affiliated Hospital of Sun Yat-sen University were searched.Contribution of the factors to prognosis was determined by multivariate analysis with Logistic regression.RESULTS In the severe community-acquired pneumonia(SCAP) subgroup,mortality was 45.0%;and in the severe hospital-acquired pneumonia(SHAP) subgroup,mortality was 54.8%.In the SCAP subgroup,there were five factors associated with prognosis on multivariate analysis: age(≥75yrs),heart failure,intubation and septic shock were risk factors;initial combined antibiotic therapy was protective factors.In the SHAP subgroup, factors associated with prognosis on multivariate analysis were heart failure,septic shock and heart rate ≥100bpm;all were risk factors.CONCLUSIONS Septic shock and heart failure are associated with mortality both in SCAP and SHAP,which suggest that severe systemic inflammatory response associated with the pulmonary infection be an important prognostic factor in the outcome of severe pneumonia.Initial appropriate antibiotic empiric therapy was important to the prognosis.