PLoS ONE (Jan 2016)

Predictors of Severe Sepsis among Patients Hospitalized for Community-Acquired Pneumonia.

  • Beatriz Montull,
  • Rosario Menéndez,
  • Antoni Torres,
  • Soledad Reyes,
  • Raúl Méndez,
  • Rafael Zalacaín,
  • Alberto Capelastegui,
  • Olga Rajas,
  • Luis Borderías,
  • Juan Martin-Villasclaras,
  • Salvador Bello,
  • Inmaculada Alfageme,
  • Felipe Rodríguez de Castro,
  • Jordi Rello,
  • Luis Molinos,
  • Juan Ruiz-Manzano,
  • NAC Calidad Group

DOI
https://doi.org/10.1371/journal.pone.0145929
Journal volume & issue
Vol. 11, no. 1
p. e0145929

Abstract

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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.