Community-acquired pneumonia in patients with chronic obstructive pulmonary disease requiring admission to the intensive care unit: Risk factors for mortality
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Date
2013
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Abstract
Purpose: The aims of this study are to identify factors predicting mortality in patients with chronic obstructive pulmonary disease (COPD) and community-acquired pneumonia (CAP) requiring intensive care unit (ICU) admission and to examine whether noninvasive ventilation treatment reduces mortality. Materials and Methods: An analysis was performed on data from patients with CAP hospitalized in the ICUs of 19 different hospitals in Turkey between October 2008 and January 2011. Predictors of mortality were assessed by both univariate and multivariate statistical analyses. Results: Two hundred eleven patients with COPD and CAP were included. The overall ICU mortality was 23.9%. Noninvasive ventilation treatment (odds ratio [OR], 0.12; 95% confidence interval [CI], 0.03-0.49; P = .003), hypertension (OR, 0.13; 95% CI, 0.02-0.93; P = .042), bilateral infiltration (OR, 13.92; 95% CI, 2.94-65.84; P = .001), systemic corticosteroid treatment (OR, 0.19; 95% CI, 0.35-0.96; P = .045), length of ICU stay (OR, 0.65; 95% CI, 0.47-0.89; P = .007), and duration of invasive mechanical ventilation (OR, 1.11; 95% CI, 1.01-1.22; P = .032) were independent factors related to mortality. Conclusion: Noninvasive ventilation, hypertension, systemic corticosteroid treatment, and shorter ICU stay are associated with reduced mortality, whereas bilateral infiltration and longer duration of invasive mechanical ventilation are associated with increased risk of mortality in patients with COPD and CAP requiring ICU admission. © 2013 Elsevier Inc.
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Keywords
Adrenal Cortex Hormones , Aged , Community-Acquired Infections , Female , Health Status Indicators , Hospital Mortality , Humans , Hypertension , Intensive Care Units , Length of Stay , Male , Pneumonia , Predictive Value of Tests , Pulmonary Disease, Chronic Obstructive , Respiration, Artificial , Risk Factors , Severity of Illness Index , Turkey , Community-acquired pneumonia , COPD , Intensive care unit , antibiotic agent , hypertensive factor , methylprednisolone , Acinetobacter infection , adult , aged , article , chronic obstructive lung disease , community acquired pneumonia , controlled study , disease exacerbation , Enterobacteriaceae infection , Escherichia coli infection , female , Gram negative infection , hospital admission , hospital patient , human , hypertension , intensive care unit , Klebsiella infection , length of stay , lung infiltrate , major clinical study , male , mortality , nonhuman , noninvasive ventilation , Parainfluenza virus infection , pneumococcal infection , prediction , Pseudomonas infection , risk assessment , risk factor , risk reduction , Serratia infection , Staphylococcus infection , systemic therapy , treatment duration , Turkey (republic)