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2019, Number 4

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Rev Méd Electrón 2019; 41 (4)

Anamnesis as mortality prognosis in the community acquired pneumonia

García ÁPJ

Language: Portugués
References: 22
Page: 889-898
PDF size: 738.30 Kb.


ABSTRACT

Introduction: community acquired pneumonia is an important health problem around the world, and in Cuba it is the fourth cause of death. Prognostic indexes help to detect early the patients at high risk, but they have low sensibility and specificity.
Objective: to determine the mortality prognostic factors in the community acquired pneumonia during the anamnesis.
Material and methods: analytic, retrospective, longitudinal study in a group applying non-parametric tests and relative risk calculation.
Results: age: 78 ± 10 years; 53 % of women. Global mortality of 57 %; 53 % had antecedents of diabetes mellitus; 34 % had previous cerebro-vascular disease, and 42 % were bedridden patients. 38 % was sick more than five days and 69 % took antimicrobials before being admitted. 23 % suffered congestive heart failure and 73 % chronic obstructive pulmonary disease. Confusional syndrome was a good predictor of mortality (x2=0.05) (RR=2.8). Long confinement to bed did not predict mortality at the fifth day (x2=0.43). The previous use of antimicrobials increased the risk (RR=0.8) con (x2=0.05). Heart failure was the best predictor (x2=0.006) (RR=1.2). Chronic obstructive pulmonary disease predicted with (x2=0.019) y (RR=1.47).
Conclusions: antecedents of heart failure and chronic obstructive pulmonary disease, and the patient arriving with confusional syndrome are considered strongly predictive factors.


REFERENCES

  1. Sharma S, Sneath E, Cheng A, et al. Community-acquired syndromes causing morbidity and mortality in Australia. Commun Dis Intell Q Rep. 2017;41(1):E49-E57. Citado en PubMed: PMC: 28385138.

  2. Caggiano S, Ullmann N, De Vitis E, et al. Factors That Negatively Affect the Prognosis of Pediatric Community-Acquired Pneumonia in District Hospital in Tanzania. Int J Mol Sci. 2017;18(3):E623. Citado en PubMed: PMC: 28335406.

  3. Sparham S, Charles P. Controversies in diagnosis and management of communityacquired pneumonia. Med J Aust. 2017;206(7):316-319. Citado en PubMed: PMC: 28403766.

  4. Bess Constantén S. Anuario estadistico de la salud [Internet]. MINSAP: Infomed; 2013 [citado 25/03/2017]. Disponible en: http://www.sld.cu/sitios/dne/

  5. Khan F, Owens M, Restrepo M, et al. Tools for outcome prediction in patients with community acquired pneumonia. Expert Rev Clin Pharmacol. 2017;10(2):201-211. Citado en PubMed: PMC: 27911103.

  6. Pilotto A, Dini S, Daragjati J, et al. Combined use of the multidimensional prognostic index (MPI) and procalcitonin serum levels in predicting 1-month mortality risk in older patients hospitalized with community-acquired pneumonia (CAP): a prospective study. Aging Clin Exp Res. 2017. Citado en PubMed: PMC: 284172.

  7. Chang P, Tsao S, Chang J, et al. Plasma levels of soluble intercellular adhesion molecule-1 as a biomarker for disease severity of patients with community-acquired pneumonia. Clin Chim Acta. 2016;463:174-180. Citado en PubMed: PMID: 27983998.

  8. Kim J, Hong D, Lee K, et al. Usefulness of plasma neutrophil gelatinase-associated lipocalin concentration for predicting the severity and mortality of patients with community-acquired pneumonia. Clin Chim Acta. 2016;462:140-145. Citado en PubMed: PMID: 27662812.

  9. Lee J, Kim Y. Predictive factors of true bacteremia and the clinical utility of blood cultures as a prognostic tool in patients with community-onset pneumonia. Medicine (Baltimore). 2016;95(41):e5058. Citado en PubMed: PMID: 27741119.

  10. Cárdenas Cruz A, Roca Guiseris J. Tratado de Medicina Intensiva. 2da. ed. Barcelona: Elsevier; 2017.

  11. Noguchi S, Yatera K, Kawanami T, et al. Pneumonia Severity Assessment Tools for Predicting Mortality in Patients with Healthcare-Associated Pneumonia: A Systematic Review and Meta-Analysis. Respiration. 2017;93(6);441-50. Citado en PubMed; PMID: 28449003.

  12. Lenz H, Norby G, Dahl V, et al. Five-year mortality in patients treated for severe community-acquired pneumonia -a retrospective study. Clin Microbiol Infect. 2017 Apr;23(4):247-252. Citado en PubMed; PMID: 28164259.

  13. Vardakas K, Trigkidis K, Falagas M. Fluoroquinolones or macrolides in combination with β-lactams in adult patients hospitalized with community acquired pneumonia: a systematic review and meta-analysis. Clin Microbiol Infect. 2017;23(4):234-241. Citado en PubMed; PMID: 27965070.

  14. Rhedin S, Galanis I, Granath F, et al. Narrow-spectrum ß-lactam monotherapy in hospital treatment of community-acquired pneumonia: a register-based cohort study. Clin Microbiol Infect. 2017r;23(4):247-252. Citado en PubMed; PMID: 28017793.

  15. Andersen S, Baunbæk Egelund G, et al. Failure of CRP decline within three days of hospitalization is associated with poor prognosis of Community-acquired Pneumonia. Infect Dis (Lond). 2017;49(4):251-260. Citado en PubMed; PMID: 27887037.

  16. Alarcón Á, Lagos I, Fica A. Gastos hospitalarios por neumonía neumocóccica invasora en adultos en un hospital general en Chile.Rev Chilena Infectol. 2016;33(4):389-94. Citado en PubMed; PMID: 27905622.

  17. Egelund G, Jensen A, Andersen S, et al. Penicillin treatment for patients with Community-Acquired Pneumonia in Denmark: a retrospective cohort study. BMC Pulm Med. 2017 20;17(1):66. Citado en PubMed; PMID: 28427381.

  18. Turktan M, Ak O, Erdem H, et al. Community acquired infections among refugees leading to Intensive Care Unit admissions in Turkey. Int J Infect Dis. 2017;58:111- 114. Citado en PubMed; PMID: 28419820.

  19. Julián Jiménez A, Parejo Miguez R, González del Castillo J. Neumonia adquirida en la comunidad. In: Julián Jiménez A, editor. Manual de protocolos de actuacion en urgencias. Castilla, La Mancha: BAYER HEALTHCARE; 2014. p. 691-706.

  20. Zilberberg M, Nathanson B, Sulham K, et al. Carbapenem resistance, inappropriate empiric treatment and outcomes among patients hospitalized with Enterobacteriaceae urinary tract infection, pneumonia and sepsis. BMC Infect Dis. 2017;17(1):279. Citado en PubMed; PMID: 28415969.

  21. Kang Y, Ryoo S, Byun S, et al. Antimicrobial Resistance and Clinical Outcomes in Nursing Home-Acquired Pneumonia, Compared to Community-Acquired Pneumonia. Yonsei Med J. 2017;58(1):180-86. Citado en PubMed; PMID: 27873512.

  22. Parrott G, Nebeya D, Kinjo T, et al. Etiological analysis and epidemiological comparison among adult CAP and NHCAP patients in Okinawa, Japan. J Infect Chemother. 2017;32(7):452-458. Citado en PubMed; PMID: 28431934.




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