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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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Martínez Sanchís, J.L. Calpe Calpe, G. Llavador Ros, J. Ena Muñoz, A. Calpe Armero" "autores" => array:5 [ 0 => array:3 [ "preGrado" => "Dr." "nombre" => "A." "apellidos" => "Martínez Sanchís" ] 1 => array:2 [ "nombre" => "J.L." "apellidos" => "Calpe Calpe" ] 2 => array:2 [ "nombre" => "G." "apellidos" => "Llavador Ros" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Ena Muñoz" ] 4 => array:2 [ "nombre" => "A." 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Gámez, M. Córdoba, I. Millán, L. Madrigal, F. Alfageme, R. Álvarez, I. Núñez, A. Varela" "autores" => array:8 [ 0 => array:3 [ "preGrado" => "Dr." "nombre" => "P." "apellidos" => "Gámez" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Córdoba" ] 2 => array:2 [ "nombre" => "I." "apellidos" => "Millán" ] 3 => array:2 [ "nombre" => "L." "apellidos" => "Madrigal" ] 4 => array:2 [ "nombre" => "F." "apellidos" => "Alfageme" ] 5 => array:2 [ "nombre" => "R." "apellidos" => "Álvarez" ] 6 => array:2 [ "nombre" => "I." "apellidos" => "Núñez" ] 7 => array:2 [ "nombre" => "A." "apellidos" => "Varela" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906603893?idApp=UINPBA00003Z" "url" => "/15792129/0000004100000001/v1_201305150128/S1579212906603893/v1_201305150128/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>" "titulo" => "Clinical Picture and Prognostic Factors for Severe Community-Acquired Pneumonia in Adults Admitted to the Intensive Care Unit" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "20" "paginaFinal" => "26" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A. Díaz, M. álvarez, C. Callejas, R. Rosso, K. Schnettler, F. Saldías" "autores" => array:6 [ 0 => array:3 [ "nombre" => "A." "apellidos" => "Díaz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "álvarez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 2 => array:3 [ "nombre" => "C." "apellidos" => "Callejas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 3 => array:3 [ "nombre" => "R." "apellidos" => "Rosso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 4 => array:3 [ "nombre" => "K." "apellidos" => "Schnettler" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 5 => array:5 [ "preGrado" => "Dr." "nombre" => "F." "apellidos" => "Saldías" "email" => array:1 [ 0 => "alediazf@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Enfermedades Respiratorias, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Seventh-year medical students, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. A. Díaz Fuenzalida. Departamento de Enfermedades Respiratorias. Pontificia Universidad Católica de Chile. Marcoleta, 345, 4.°. Santiago de Chile. Chile" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-01-27" "fechaAceptado" => "2004-04-06" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec153657" "palabras" => array:6 [ 0 => "Pneumonia" 1 => "Community" 2 => "Severe" 3 => "Intensive care" 4 => "Prognosis" 5 => "Risk" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153656" "palabras" => array:6 [ 0 => "Neumonía" 1 => "Comunidad" 2 => "Grave" 3 => "Cuidados intensivos" 4 => "Pronóstico" 5 => "Riesgo" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "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. This study describes the clinical picture, prognostic factors, and treatment of adult patients admitted to the intensive care unit for severe community-acquired pneumonia.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 113 consecutive patients were included in this prospective, descriptive study.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">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).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The patients with severe pneumonia admitted to the intensive care unit are elderly, with a high level of comorbidity and complications, but most survive.</p><p class="elsevierStyleSimplePara elsevierViewall">Cuadro clínico y factores pronósticos de la neumonía adquirida en la comunidad grave en adultos hospitalizados en la unidad de cuidados intensivos</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">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.</p> <span class="elsevierStyleSectionTitle">Pacientes Y Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un estudio clínico prospectivo y descriptivo que ha incluido a 113 pacientes consecutivos.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">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).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">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.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:33 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology of community-acquired respiratory tract infections in adults. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 6 | 3 | 9 |
| 2024 October | 30 | 19 | 49 |
| 2024 September | 29 | 12 | 41 |
| 2024 August | 41 | 33 | 74 |
| 2024 July | 26 | 20 | 46 |
| 2024 June | 22 | 28 | 50 |
| 2024 May | 29 | 19 | 48 |
| 2024 April | 18 | 22 | 40 |
| 2024 March | 20 | 11 | 31 |
| 2024 February | 19 | 21 | 40 |
| 2023 March | 2 | 1 | 3 |
| 2023 February | 14 | 19 | 33 |
| 2023 January | 22 | 28 | 50 |
| 2022 December | 18 | 16 | 34 |
| 2022 November | 18 | 15 | 33 |
| 2022 October | 17 | 24 | 41 |
| 2022 September | 12 | 22 | 34 |
| 2022 August | 19 | 33 | 52 |
| 2022 July | 12 | 35 | 47 |
| 2022 June | 13 | 30 | 43 |
| 2022 May | 16 | 27 | 43 |
| 2022 April | 11 | 21 | 32 |
| 2022 March | 11 | 36 | 47 |
| 2022 February | 16 | 19 | 35 |
| 2022 January | 10 | 20 | 30 |
| 2021 December | 15 | 34 | 49 |
| 2021 November | 9 | 31 | 40 |
| 2021 October | 16 | 37 | 53 |
| 2021 September | 15 | 32 | 47 |
| 2021 August | 31 | 32 | 63 |
| 2021 July | 41 | 28 | 69 |
| 2021 June | 21 | 26 | 47 |
| 2021 May | 35 | 22 | 57 |
| 2021 April | 60 | 52 | 112 |
| 2021 March | 20 | 14 | 34 |
| 2021 February | 14 | 16 | 30 |
| 2021 January | 8 | 7 | 15 |
| 2020 December | 6 | 10 | 16 |
| 2020 November | 9 | 11 | 20 |
| 2020 October | 7 | 8 | 15 |
| 2020 September | 8 | 1 | 9 |
| 2020 August | 6 | 6 | 12 |
| 2020 July | 7 | 15 | 22 |
| 2020 June | 5 | 6 | 11 |
| 2020 May | 17 | 12 | 29 |
| 2020 April | 2 | 10 | 12 |
| 2020 March | 9 | 15 | 24 |
| 2020 February | 13 | 13 | 26 |
| 2020 January | 13 | 18 | 31 |
| 2019 December | 8 | 11 | 19 |
| 2019 November | 10 | 13 | 23 |
| 2019 October | 6 | 6 | 12 |
| 2019 September | 9 | 14 | 23 |
| 2019 August | 21 | 14 | 35 |
| 2019 July | 11 | 22 | 33 |
| 2019 June | 4 | 11 | 15 |
| 2019 May | 11 | 9 | 20 |
| 2019 April | 30 | 22 | 52 |
| 2019 March | 13 | 16 | 29 |
| 2019 February | 16 | 24 | 40 |
| 2019 January | 10 | 12 | 22 |
| 2018 December | 8 | 16 | 24 |
| 2018 November | 25 | 7 | 32 |
| 2018 October | 27 | 16 | 43 |
| 2018 September | 8 | 9 | 17 |
| 2018 May | 6 | 0 | 6 |
| 2018 April | 9 | 6 | 15 |
| 2018 March | 3 | 3 | 6 |
| 2018 February | 7 | 7 | 14 |
| 2018 January | 4 | 4 | 8 |
| 2017 December | 5 | 12 | 17 |
| 2017 November | 4 | 5 | 9 |
| 2017 October | 6 | 9 | 15 |
| 2017 September | 6 | 11 | 17 |
| 2017 August | 8 | 12 | 20 |
| 2017 July | 6 | 8 | 14 |
| 2017 June | 10 | 15 | 25 |
| 2017 May | 5 | 17 | 22 |
| 2017 April | 3 | 16 | 19 |
| 2017 March | 1 | 7 | 8 |
| 2017 February | 1 | 3 | 4 |
| 2017 January | 2 | 6 | 8 |
| 2016 December | 9 | 8 | 17 |
| 2016 November | 17 | 6 | 23 |
| 2016 October | 12 | 12 | 24 |
| 2016 September | 18 | 5 | 23 |
| 2016 August | 11 | 3 | 14 |
| 2016 July | 3 | 3 | 6 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 43 | 1 | 44 |
| 2015 September | 44 | 13 | 57 |
| 2015 August | 41 | 11 | 52 |
| 2015 July | 34 | 5 | 39 |
| 2015 June | 33 | 7 | 40 |
| 2015 May | 46 | 6 | 52 |
| 2015 April | 42 | 4 | 46 |
| 2015 March | 32 | 6 | 38 |
| 2015 February | 40 | 15 | 55 |
| 2015 January | 27 | 11 | 38 |
| 2014 December | 33 | 4 | 37 |
| 2014 November | 28 | 4 | 32 |
| 2014 October | 36 | 9 | 45 |
| 2014 September | 44 | 12 | 56 |
| 2014 August | 36 | 10 | 46 |
| 2014 July | 38 | 8 | 46 |
| 2014 June | 47 | 11 | 58 |
| 2014 May | 46 | 9 | 55 |
| 2014 April | 50 | 8 | 58 |
| 2014 March | 74 | 12 | 86 |
| 2014 February | 59 | 7 | 66 |
| 2014 January | 47 | 10 | 57 |
| 2013 December | 36 | 9 | 45 |
| 2013 November | 31 | 7 | 38 |
| 2013 October | 44 | 8 | 52 |
| 2013 September | 32 | 6 | 38 |
| 2013 August | 51 | 5 | 56 |
| 2013 July | 48 | 13 | 61 |
| 2013 June | 29 | 11 | 40 |
| 2013 May | 47 | 4 | 51 |
| 2013 April | 25 | 6 | 31 |
| 2013 March | 7 | 2 | 9 |
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