The influence of chronic obstructive pulmonary disease on mortality in patients admitted to the intensive care unit for community-acquired pneumonia
- Author:
- No author available
- Journal Title:
- CHINA MEDICINE
- Issue:
- 11
- DOI:
- 10.3760/cma.j.issn.1673-4777.2010.11.006
- Key Word:
- 肺炎;社区获得性感染;危险因素;Pneumonia;Community-acquired infections;Risk factors
Abstract： Objective To analyze the influence of chronic obstructive pulmonary disease(COPD)on mortality in patients admitted to the intensive care unit for severe community-acquired pneumonia(SCAP). Methods The clinic characteristics,aetiology and evolution of patients with SCAP admitted to our hospital between 2004 and 2009 were analyzed retrospectively.COPD patients were compared with non-COPD patients in baseline characters,etiology and prognosis parameters.The univariate and multiple logistic regression analysis was used for statistical analysis. Results A total of 166 patients was included with a mean age of 72.3 yrs.There were 125 survivors and 41 death,and in-hospital mortality was 24.7%.The proportion of patients who were males(80.6%),smokers (62.7%),infection of Pseudomonas aeruginosa(13.4%),need of mechanical ventilation(31.3%),use of glucocorticoid(52.2%)and ICU mortality(29.9%)was higher in COPD patients.In multivariate analysis the prognostic factors independently associated with in-hospital mortality were coexisting of COPD(OR = 8.1,95% CI:4.7-23.9,P ＜0.01),multilobar or bilateral involvement(OR =9.3,95% CI:4.5-26.3 ,P ＜0.001)and development of shock(OR=7.0,95% CI:3.2-19.4,P＜0.01). Conclusion COPD patients hospitalized with SCAP in the intensive care unit have higher mortality and need more mechanical ventilation compared with patients without chronic obstructive pulmonary disease.
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