| Abstract | dc.description.abstract | Background: Severity assessment of community-acquired
pneumonia (CAP) patients allows the clinician to decide the place of management and guide
empirical antimicrobial treatment. Aim: To assess admission prognostic factors and outcome of CAP
in immunocompetent adult patients hospitalized in 21 medical centers in Chile. Material and
methods: Prospective evaluation of non immunocompromised adults with CAP admitted to 21
Chilean hospitals between July and August, 1999. All patients were assessed on admission and
followed until discharge or death. Results: During the study period, 1,194 patients (aged 68 ±17
years, 573 males) were evaluated. Seventy two percent had an underlying disease (especially
chronic cardiovascular, neurological, respiratory diseases and diabetes mellitus), and 90% were
treated with ß-lactamic agents (especially a third generation cephalosporin or penicillin). Mean
hospital length of stay was 11 ±9 days, 10% were admitted to Intermediate Care or Intensive Care
Units (ICU), 6% were mechanically ventilated and in-hospital mortality was 15.7%. Admission
prognostic factors associated with hospital mortality were: advanced age, male gender, presence of
comorbidity (chronic cardiovascular, renal, neurological and hepatic disease), undernutrition,
suspicion of aspiration, altered mental status, low blood pressure, tachypnea, absence of fever, high
blood urea nitrogen, multilobar radiographic pulmonary infiltrates, high risk categories from
Chilean Respiratory Diseases Society Consensus, admission to Intermediate Care Units or ICU, and
mechanical ventilation. In the multivariate analysis, prognostic factors associated with high hospital
mortality were: mental confusion, high blood urea nitrogen, multilobar pneumonia, presence of
comorbidity and absence of fever on admission. | en |
