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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">In Chile very little information is available on severe community-acquired pneumonia treated in intensive care units&#46; This study describes the clinical picture&#44; prognostic factors&#44; and treatment of adult patients admitted to the intensive care unit for severe community-acquired pneumonia&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 113 consecutive patients were included in this prospective&#44; descriptive study&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The mean &#40;SD&#41; age of the 113 patients was 73 &#40;15&#41;&#46; Of these&#44; 95&#37; had associated comorbidity&#44; and 81&#37; were in the high-risk classes of the Pneumonia Severity Index&#46; Etiology was identified in 31&#37;&#44; and the most common pathogens were Streptococcus pneumoniae &#40;40&#37;&#41;&#44; gram negative bacilli &#40;17&#37;&#41;&#44; and Mycoplasma pneumoniae &#40;6&#37;&#41;&#46; The main complications were the need for mechanical ventilation &#40;45&#37;&#41;&#44; septic shock &#40;26&#37;&#41;&#44; heart failure &#40;24&#37;&#41;&#44; and arrhythmias &#40;15&#37;&#41;&#46; Mortality at 30 days was 16&#46;8&#37;&#44; and multivariate analysis revealed the following factors to be associated with a greater risk of death&#58; acute renal failure &#40;odds ratio&#58; 5&#46;1&#41;&#44; and glycemia above 300 mg&#47;dL &#40;odds ratio&#58; 7&#46;2&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The patients with severe pneumonia admitted to the intensive care unit are elderly&#44; with a high level of comorbidity and complications&#44; but most survive&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Cuadro cl&#237;nico y factores pron&#243;sticos de la neumon&#237;a adquirida en la comunidad grave en adultos hospitalizados en la unidad de cuidados intensivos</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">En Chile existe escasa informaci&#243;n acerca de la neumon&#237;a adquirida en la comunidad de car&#225;cter grave ma-nejada en las unidades de cuidados intensivos&#46; En este tra-bajo se describen el cuadro cl&#237;nico&#44; los factores pron&#243;sticos y el tratamiento de pacientes adultos hospitalizados en la unidad de cuidados intensivos por neumon&#237;a adquirida en la comunidad grave&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes Y M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un estudio cl&#237;nico prospectivo y descriptivo que ha incluido a 113 pacientes consecutivos&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">De los 113 pacientes incluidos &#40;edad media &#177; desviaci&#243;n est&#225;ndar&#58; 73 &#177; 15 a&#241;os&#41;&#44; el 95&#37; ten&#237;a comorbili-dad asociada y un 81&#37; pertenec&#237;a a las categor&#237;as de alto riesgo del &#237;ndice de gravedad de la neumon&#237;a &#40;Pneumonia Severity Index&#41;&#46; Se demostr&#243; la etiolog&#237;a en el 31&#37; y los pa-t&#243;genos m&#225;s frecuentes fueron Streptococcus pneumoniae &#40;40&#37;&#41;&#44; bacilos gramnegativos &#40;17&#37;&#41; y Mycoplasma pneumoniae &#40;6&#37;&#41;&#46; Las principales complicaciones fueron necesidad de ventilaci&#243;n mec&#225;nica &#40;45&#37;&#41;&#44; shock s&#233;ptico &#40;26&#37;&#41;&#44; insuficiencia card&#237;aca &#40;24&#37;&#41; y arritmias &#40;15&#37;&#41;&#46; La mortalidad a los 30 d&#237;as fue del 16&#44;8&#37; y mediante un an&#225;lisis multivaria-do se identificaron los siguientes factores asociados a mayor riesgo de muerte&#58; insuficiencia renal aguda &#40;odds ratio &#61; 5&#44;1&#41; y glucemia mayor de 300 mg&#47;dl &#40;odds ratio &#61; 7&#44;2&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los pacientes con neumon&#237;a grave ingresados en la unidad de cuidados intensivos son de edad avan-zada&#44; con una alta tasa de comorbilidad y complicaciones&#44; pero la mayor&#237;a sobrevive&#46;</p>"
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Vol. 41. Issue 1.
Pages 20-26 (January 2005)
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Vol. 41. Issue 1.
Pages 20-26 (January 2005)
Original Articles
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Clinical Picture and Prognostic Factors for Severe Community-Acquired Pneumonia in Adults Admitted to the Intensive Care Unit
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A. Díaza, M. álvareza, C. Callejasb, R. Rossob, K. Schnettlerb, F. Saldíasa,
Corresponding author
alediazf@hotmail.com

Correspondence: Dr. A. Díaz Fuenzalida. Departamento de Enfermedades Respiratorias. Pontificia Universidad Católica de Chile. Marcoleta, 345, 4.°. Santiago de Chile. Chile
a Departamento de Enfermedades Respiratorias, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
b Seventh-year medical students, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
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Objective

In Chile very little information is available on severe community-acquired pneumonia treated in intensive care units. This study describes the clinical picture, prognostic factors, and treatment of adult patients admitted to the intensive care unit for severe community-acquired pneumonia.

Patients and methods

A total of 113 consecutive patients were included in this prospective, descriptive study.

Results

The mean (SD) age of the 113 patients was 73 (15). Of these, 95% had associated comorbidity, and 81% were in the high-risk classes of the Pneumonia Severity Index. Etiology was identified in 31%, and the most common pathogens were Streptococcus pneumoniae (40%), gram negative bacilli (17%), and Mycoplasma pneumoniae (6%). The main complications were the need for mechanical ventilation (45%), septic shock (26%), heart failure (24%), and arrhythmias (15%). Mortality at 30 days was 16.8%, and multivariate analysis revealed the following factors to be associated with a greater risk of death: acute renal failure (odds ratio: 5.1), and glycemia above 300 mg/dL (odds ratio: 7.2).

Conclusions

The patients with severe pneumonia admitted to the intensive care unit are elderly, with a high level of comorbidity and complications, but most survive.

Cuadro clínico y factores pronósticos de la neumonía adquirida en la comunidad grave en adultos hospitalizados en la unidad de cuidados intensivos

Key Words:
Pneumonia
Community
Severe
Intensive care
Prognosis
Risk
Objetivo

En Chile existe escasa información acerca de la neumonía adquirida en la comunidad de carácter grave ma-nejada en las unidades de cuidados intensivos. En este tra-bajo se describen el cuadro clínico, los factores pronósticos y el tratamiento de pacientes adultos hospitalizados en la unidad de cuidados intensivos por neumonía adquirida en la comunidad grave.

Pacientes Y Métodos

Se ha realizado un estudio clínico prospectivo y descriptivo que ha incluido a 113 pacientes consecutivos.

Resultados

De los 113 pacientes incluidos (edad media ± desviación estándar: 73 ± 15 años), el 95% tenía comorbili-dad asociada y un 81% pertenecía a las categorías de alto riesgo del índice de gravedad de la neumonía (Pneumonia Severity Index). Se demostró la etiología en el 31% y los pa-tógenos más frecuentes fueron Streptococcus pneumoniae (40%), bacilos gramnegativos (17%) y Mycoplasma pneumoniae (6%). Las principales complicaciones fueron necesidad de ventilación mecánica (45%), shock séptico (26%), insuficiencia cardíaca (24%) y arritmias (15%). La mortalidad a los 30 días fue del 16,8% y mediante un análisis multivaria-do se identificaron los siguientes factores asociados a mayor riesgo de muerte: insuficiencia renal aguda (odds ratio = 5,1) y glucemia mayor de 300 mg/dl (odds ratio = 7,2).

Conclusiones

Los pacientes con neumonía grave ingresados en la unidad de cuidados intensivos son de edad avan-zada, con una alta tasa de comorbilidad y complicaciones, pero la mayoría sobrevive.

Palabras clave:
Neumonía
Comunidad
Grave
Cuidados intensivos
Pronóstico
Riesgo
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Copyright © 2005. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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