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Outcomes and Prognostic Factors for Severe Community-Acquired Pneumonia that Requires Mechanical Ventilation

Lee, Jin Hwa    (Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.   ); Ryu, Yon Ju    (Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.   ); Chun, Eun Mi    (Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.   ); Chang, Jung Hyun    (Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.  );
  • 초록

    Background Community-acquired pneumonia (CAP) remains a common and serious condition worldwide. The mortality from severe CAP remains high, and this has reached 50% in some series. This study was conducted to determine the mortality and predictors that contribute to in-hospital mortality for patients who exhibit CAP and acute respiratory failure that requires mechanical ventilation. Methods We retrospectively reviewed the medical records of 85 patients with severe CAP as a primary cause of acute respiratory failure, and this required mechanical ventilation in a setting of the medical intensive care unit (ICU) of a tertiary university hospital between 2000 and 2003. Results The overall in-hospital mortality was 56% (48/85). A Cox-proportional hazard model revealed that the independent predictive factors of in-hospital mortality included a PaCO 2 of less than 45 mmHg ( p p = 0.006, RR: 2.46, 95% CI: 1.29-4.66) and a high APACHE II score ( p = 0.004, RR: 1.09, 95% CI: 1.03-1.16). Conclusions Acute respiratory failure caused by severe CAP and that necessitates mechanical ventilation is associated with a high mortality rate. Initial hypercapnia and a large urine output favored survival, whereas a high APACHE II score predicted mortality.


  • 주제어

    APACHE .   Hypercapnia .   Mechanical ventilation .   Mortality .   Pneumonia.  

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