Low C-reactive protein values at admission predict mortality in patients with severe community-acquired pneumonia caused by Streptococcus pneumoniae that require intensive care management.

Détails

ID Serval
serval:BIB_237BD48AFB69
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Low C-reactive protein values at admission predict mortality in patients with severe community-acquired pneumonia caused by Streptococcus pneumoniae that require intensive care management.
Périodique
Infection
Auteur(s)
Que Y.A., Virgini V., Lozeron E.D., Paratte G., Prod'hom G., Revelly J.P., Pagani J.L., Charbonney E., Eggimann P.
ISSN
1439-0973 (Electronic)
ISSN-L
0300-8126
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
43
Numéro
2
Pages
193-199
Langue
anglais
Notes
Publication types: Journal Article Publication Status: ppublish
Résumé
PURPOSE: To identify risk factors associated with mortality in patients with severe community-acquired pneumonia (CAP) caused by S. pneumoniae who require intensive care unit (ICU) management, and to assess the prognostic values of these risk factors at the time of admission.
METHODS: Retrospective analysis of all consecutive patients with CAP caused by S. pneumoniae who were admitted to the 32-bed medico-surgical ICU of a community and referral university hospital between 2002 and 2011. Univariate and multivariate analyses were performed on variables available at admission.
RESULTS: Among the 77 adult patients with severe CAP caused by S. pneumoniae who required ICU management, 12 patients died (observed mortality rate 15.6 %). Univariate analysis indicated that septic shock and low C-reactive protein (CRP) values at admission were associated with an increased risk of death. In a multivariate model, after adjustment for age and gender, septic shock [odds ratio (OR), confidence interval 95 %; 4.96, 1.11-22.25; p = 0.036], and CRP (OR 0.99, 0.98-0.99 p = 0.034) remained significantly associated with death. Finally, we assessed the discriminative ability of CRP to predict mortality by computing its receiver operating characteristic curve. The CRP value cut-off for the best sensitivity and specificity was 169.5 mg/L to predict hospital mortality with an area under the curve of 0.72 (0.55-0.89).
CONCLUSIONS: The mortality of patients with S. pneumoniae CAP requiring ICU management was much lower than predicted by severity scores. The presence of septic shock and a CRP value at admission <169.5 mg/L predicted a fatal outcome.
Pubmed
Web of science
Création de la notice
01/05/2015 17:50
Dernière modification de la notice
03/03/2018 14:54
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