Open AccessPredictors of Severe Sepsis among Patients Hospitalized for Community-Acquired Pneumonia
Author(s) -
Beatriz Montull,
Rosário Menéndez,
Antoni Torres,
Soledad Reyes,
Raúl Méndez,
Rafael Zalacaín,
Alberto Capelastegui,
Olga Rajas,
Luis Borderìas,
Juan José Martín-Villasclaras,
Salvador Bello,
Inmaculada Alfageme,
Felipè Rodríguez de Castro,
Jordi Rello,
Luis Molinos,
Juan Ruiz-Manzano
Publication year - 2016
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0145929
Subject(s) - medicine , sepsis , pneumonia , copd , bacteremia , prospective cohort study , etiology , community acquired pneumonia , cohort study , antibiotics , microbiology and biotechnology , biology
Background Severe sepsis, may be present on hospital arrival in approximately one-third of patients with community-acquired pneumonia (CAP). Objective To determine the host characteristics and micro-organisms associated with severe sepsis in patients hospitalized with CAP. Results We performed a prospective multicenter cohort study in 13 Spanish hospital, on 4070 hospitalized CAP patients, 1529 of whom (37.6%) presented with severe sepsis. Severe sepsis CAP was independently associated with older age (>65 years), alcohol abuse (OR, 1.31; 95% CI, 1.07–1.61), chronic obstructive pulmonary disease (COPD) (OR, 1.75; 95% CI, 1.50–2.04) and renal disease (OR, 1.57; 95% CI, 1.21–2.03), whereas prior antibiotic treatment was a protective factor (OR, 0.62; 95% CI, 0.52–0.73). Bacteremia (OR, 1.37; 95% CI, 1.05–1.79), S pneumoniae (OR, 1.59; 95% CI, 1.31–1.95) and mixed microbial etiology (OR, 1.65; 95% CI, 1.10–2.49) were associated with severe sepsis CAP. Conclusions CAP patients with COPD, renal disease and alcohol abuse, as well as those with CAP due to S pneumonia or mixed micro-organisms are more likely to present to the hospital with severe sepsis.