Community-acquired pneumonia in patients with chronic obstructive pulmonary disease requiring admission to the intensive care unit: risk factors for mortality.

Abstract

PURPOSE:

The aims of this study are to identify factors predicting mortality in patients with chronic obstructive pulmonary disease (COPD) and community-acquired pneumonia (CAP) requiring intensive care unit (ICU) admission and to examine whether noninvasive ventilation treatment reduces mortality.

MATERIALS AND METHODS:

An analysis was performed on data from patients with CAP hospitalized in the ICUs of 19 different hospitals in Turkey between October 2008 and January 2011. Predictors of mortality were assessed by both univariate and multivariate statistical analyses.

RESULTS:

Two hundred eleven patients with COPD and CAP were included. The overall ICU mortality was 23.9%. Noninvasive ventilation treatment (odds ratio [OR], 0.12; 95% confidence interval [CI], 0.03-0.49; P = .003), hypertension (OR, 0.13; 95% CI, 0.02-0.93; P = .042), bilateral infiltration (OR, 13.92; 95% CI, 2.94-65.84; P = .001), systemic corticosteroid treatment (OR, 0.19; 95% CI, 0.35-0.96; P = .045), length of ICU stay (OR, 0.65; 95% CI, 0.47-0.89; P = .007), and duration of invasive mechanical ventilation (OR, 1.11; 95% CI, 1.01-1.22; P = .032) were independent factors related to mortality.

CONCLUSION:

Noninvasive ventilation, hypertension, systemic corticosteroid treatment, and shorter ICU stay are associated with reduced mortality, whereas bilateral infiltration and longer duration of invasive mechanical ventilation are associated with increased risk of mortality in patients with COPD and CAP requiring ICU admission.

• Authors: Aykut Cilli, Hakan Erdem, Zuhal Karakurt, Hulya Turkan, Ozlem Yazicioglu-Mocin, Nalan Adiguzel, Gokay Gungor, Ugur Bilge, Canturk Tasci, Gulden Yilmaz, Oral Oncul, Aygul Dogan-Celik, Ozcan Erdemli, Nefise Oztoprak, Anil Aktas Samur, Yakup Tomak, Asuman Inan, Burcu Karaboga, Demet Tok, Sibel Temur, Hafize Oksuz, Ozgur Senturk, Unase Buyukkocak, Fatma Yilmaz-Karadag, Dilek Ozcengiz, Ahmet Karakas, Umit Savasci, Aylin Ozgen-Alpaydın, Erol Kilic, Nazif Elaldi, Hayati Bilgic
• Journal: Journal of critical care (J Crit Care) Vol. 28 Issue 6 Pg. 975-9 (Dec 2013) ISSN: 1557-8615 [Electronic] United States
• PMID: 24075301 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2013.

Chemical References

• Adrenal Cortex Hormones

Topics

• Adrenal Cortex Hormones (administration & dosage)
• Aged
• Community-Acquired Infections (complications, mortality)
• Female
• Health Status Indicators
• Hospital Mortality
• Humans
• Hypertension (complications)
• Intensive Care Units
• Length of Stay (statistics & numerical data)
• Male
• Pneumonia (complications, mortality)
• Predictive Value of Tests
• Pulmonary Disease, Chronic Obstructive (complications, mortality)
• Respiration, Artificial (adverse effects)
• Risk Factors
• Severity of Illness Index
• Turkey (epidemiology)