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[Factors effecting the duration of hospitalization and mortality in patients with community-acquired pneumonia].
Mikrobiyol Bul. 2009 Oct; 43(4):597-606.MB

Abstract

Community-acquired pneumonia (CAP) is a common infectious disease with high morbidity and mortality. In this study, demographic features, underlying conditions, causative pathogens and factors affecting length of hospital stay and mortality were retrospectively investigated in patients who were diagnosed as CAP and followed-up in our unit between January 2005-December 2007. Among 97 patients 65 (67%) were male, 32 (33%) were female and the mean age was 62.7 (age range: 18-94) years. Patients were grouped according to criteria of Turkish Thoracic Society into four groups; 22 were group 2 (patients with risk factors, without aggrevating factors), 59 were group 3 (patients with aggrevating factors), and 16 were group 4 (patients who have necessity for intensive care) CAP. The patients have also been grouped according to criteria of American Thoracic Society (CURB-65 score = Confusion, Urea > 7 mmol/L, Respiratory rate > or = 30/min, low Blood pressure and being > or = 65 years old), as group I (n = 65), group II (n = 20), and group III (n = 12). During follow-up 11 (11.3%) patients required mechanical ventilation support and 6 (6.2%) patients have died. Causative pathogens were isolated from 14 (23.3%) out of 27 well-qualified sputum samples obtained from 60 patients who could produce sputum (8 Streptococcus pneumoniae, 2 methicillin-sensitive Staphylococcus aureus, 2 Klebsiella pneumoniae, 1 Haemophilus influenzae, 1 Moraxella catarrhalis). Thirty-seven of cases were treated with levofloxacin, 10 with moxifloxacin, 24 with ceftriaxone +/- clarithromycin, 16 with sulbactam-ampicillin +/- ciprofloxacin, 10 with beta-lactam/beta-lactamase inhibitor combinations, and fever declined within 2.5 days in 83 (85.6%) of them. The mean duration of hospital stay was estimated as 11.1 days. In the evaluation of the factors that affect the length of hospital stay, being > or = 65 years old, gender, underlying conditions, central venous catheterisation, presence of nasogastric tube, positive culture result, previous antibiotic treatment, fever continuing for > 3 days despite antibiotic therapy and scoring groups were not determined as risk factors (p > 0.05 for all of these parameters). However, mechanical ventilation was found as a significant risk factor (p < 0.05). In the evaluation of the factors that affect mortality, mechanical ventilation (p < 0.001), staying in intensive care unit (p < 0.001), being group 4 CAP (p < 0.001) and fever continuing for > 3 days despite antibiotic therapy (p = 0.05) were found to be significant risk factors. In conclusion, length of hospital stay, mortality and treatment costs in CAP patients could be reduced by defining the risk factors and starting empirical antibiotic therapy according to the national and international guidelines.

Authors+Show Affiliations

Zonguldak Karaelmas Universitesi Tip Fakültesi, Enfeksiyon Hastaliklari ve Klinik Mikrobiyoloji Anabilim Dali, Zonguldak. nihal_piskin@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

tur

PubMed ID

20084912

Citation

Pişkin, Nihal, et al. "[Factors Effecting the Duration of Hospitalization and Mortality in Patients With Community-acquired Pneumonia]." Mikrobiyoloji Bulteni, vol. 43, no. 4, 2009, pp. 597-606.
Pişkin N, Aydemir H, Oztoprak N, et al. [Factors effecting the duration of hospitalization and mortality in patients with community-acquired pneumonia]. Mikrobiyol Bul. 2009;43(4):597-606.
Pişkin, N., Aydemir, H., Oztoprak, N., Akduman, D., Celebi, G., & Seremet Keskin, A. (2009). [Factors effecting the duration of hospitalization and mortality in patients with community-acquired pneumonia]. Mikrobiyoloji Bulteni, 43(4), 597-606.
Pişkin N, et al. [Factors Effecting the Duration of Hospitalization and Mortality in Patients With Community-acquired Pneumonia]. Mikrobiyol Bul. 2009;43(4):597-606. PubMed PMID: 20084912.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Factors effecting the duration of hospitalization and mortality in patients with community-acquired pneumonia]. AU - Pişkin,Nihal, AU - Aydemir,Hande, AU - Oztoprak,Nefise, AU - Akduman,Deniz, AU - Celebi,Güven, AU - Seremet Keskin,Ayşegül, PY - 2010/1/21/entrez PY - 2010/1/21/pubmed PY - 2010/9/3/medline SP - 597 EP - 606 JF - Mikrobiyoloji bulteni JO - Mikrobiyol Bul VL - 43 IS - 4 N2 - Community-acquired pneumonia (CAP) is a common infectious disease with high morbidity and mortality. In this study, demographic features, underlying conditions, causative pathogens and factors affecting length of hospital stay and mortality were retrospectively investigated in patients who were diagnosed as CAP and followed-up in our unit between January 2005-December 2007. Among 97 patients 65 (67%) were male, 32 (33%) were female and the mean age was 62.7 (age range: 18-94) years. Patients were grouped according to criteria of Turkish Thoracic Society into four groups; 22 were group 2 (patients with risk factors, without aggrevating factors), 59 were group 3 (patients with aggrevating factors), and 16 were group 4 (patients who have necessity for intensive care) CAP. The patients have also been grouped according to criteria of American Thoracic Society (CURB-65 score = Confusion, Urea > 7 mmol/L, Respiratory rate > or = 30/min, low Blood pressure and being > or = 65 years old), as group I (n = 65), group II (n = 20), and group III (n = 12). During follow-up 11 (11.3%) patients required mechanical ventilation support and 6 (6.2%) patients have died. Causative pathogens were isolated from 14 (23.3%) out of 27 well-qualified sputum samples obtained from 60 patients who could produce sputum (8 Streptococcus pneumoniae, 2 methicillin-sensitive Staphylococcus aureus, 2 Klebsiella pneumoniae, 1 Haemophilus influenzae, 1 Moraxella catarrhalis). Thirty-seven of cases were treated with levofloxacin, 10 with moxifloxacin, 24 with ceftriaxone +/- clarithromycin, 16 with sulbactam-ampicillin +/- ciprofloxacin, 10 with beta-lactam/beta-lactamase inhibitor combinations, and fever declined within 2.5 days in 83 (85.6%) of them. The mean duration of hospital stay was estimated as 11.1 days. In the evaluation of the factors that affect the length of hospital stay, being > or = 65 years old, gender, underlying conditions, central venous catheterisation, presence of nasogastric tube, positive culture result, previous antibiotic treatment, fever continuing for > 3 days despite antibiotic therapy and scoring groups were not determined as risk factors (p > 0.05 for all of these parameters). However, mechanical ventilation was found as a significant risk factor (p < 0.05). In the evaluation of the factors that affect mortality, mechanical ventilation (p < 0.001), staying in intensive care unit (p < 0.001), being group 4 CAP (p < 0.001) and fever continuing for > 3 days despite antibiotic therapy (p = 0.05) were found to be significant risk factors. In conclusion, length of hospital stay, mortality and treatment costs in CAP patients could be reduced by defining the risk factors and starting empirical antibiotic therapy according to the national and international guidelines. SN - 0374-9096 UR - https://www.unboundmedicine.com/medline/citation/20084912/[Factors_effecting_the_duration_of_hospitalization_and_mortality_in_patients_with_community_acquired_pneumonia]_ DB - PRIME DP - Unbound Medicine ER -