engleski

Treatment outcome and clinical characteristics of patients with community-acquired pneumonia treated in an infectious disease intensive care unit

Background: Patients admitted to an intensive care unit with a primary diagnosis of community- acquired pneumonia (CAP) have a high in-hospital mortality rate and often demand complex treatment. This study aimed to evaluate the clinical and epidemiological characteristics of patients with severe CAP, as well as to compare treatment outcomes in an infectious disease intensive care unit (IDICU) with the literature data on the outcome of patients with severe CAP in non-IDICUs. Materials/methods: This research is a retrospective analysis of data collected on 305 patients treated in an IDICU with a primary diagnosis of CAP in the period between January 2016 and December 2018 in an 18 bed IDICU of University Hospital for Infectious Diseases in Zagreb, Croatia. Results: The research included 305 patients (67% male) with CAP, with a median age of 63 years (IQR 50-71), median Charlson Comorbidity Index of 3 (IQR 2-5) and a median APACHE II score of 16 (IQR 13-22). The average length of hospital stay was 14 days. The most frequent infectious agents were the influenza virus and Streptococcus pneumoniae. CAP was complicated with sepsis in 15 % of the cases. Almost 50% of the patients developed multiple organ failure (MOF). Around two thirds of the treated CAP patients required some method of intensive medicine life support, most commonly mechanical ventilation (67%), hemodialysis (34%) and VV ECMO (18%). The most common complications were ARDS, pleural effusion and pneumothorax. At discharge only 14% of the patients were completely independent, 30% had reduced functional ability and 27% of the discharged patients were completely dependent and immobile. The specific in-hospital mortality rate for CAP was 28%. Conclusions: Patients treated for CAP in an IDICU have numerous comorbidities and severe forms of this disease regularly requiring ICU life support. The in-hospital mortality of CAP in IDICU was lower than the CAP mortality of patients with similar APACHE II score in non-IDICUs (32-55%) as stated in the literature. This could indicate that treatment outcome could depend on patient characteristics but also on the type of ICU.

Treatment ; community-acquired pneumonia ; infectious disease ; intensive care unit

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