Risk factors for mortality in patients admitted to intensive care units with pneumonia
Despite the high mortality in patients with pneumonia admitted to an ICU, data on risk factors for death remain limited. In this secondary analysis of PROTECT (Prophylaxis for Thromboembolism in Critical Care Trial), we focused on the patients admitted to ICU with a primary diagnosis of pneumonia. T...
Gespeichert in:
| Veröffentlicht in: | Respiratory research 2016-07, Vol.17 (1), p.80-80, Article 80 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 80 |
|---|---|
| container_issue | 1 |
| container_start_page | 80 |
| container_title | Respiratory research |
| container_volume | 17 |
| creator | Li, Guowei Cook, Deborah J Thabane, Lehana Friedrich, Jan O Crozier, Tim M Muscedere, John Granton, John Mehta, Sangeeta Reynolds, Steven C Lopes, Renato D Lauzier, Francois Freitag, Andreas P Levine, Mitchell A H |
| description | Despite the high mortality in patients with pneumonia admitted to an ICU, data on risk factors for death remain limited.
In this secondary analysis of PROTECT (Prophylaxis for Thromboembolism in Critical Care Trial), we focused on the patients admitted to ICU with a primary diagnosis of pneumonia. The primary outcome for this study was 90-day hospital mortality and the secondary outcome was 90-day ICU mortality. Cox regression model was conducted to examine the relationship between baseline and time-dependent variables and hospital and ICU mortality.
Six hundred sixty seven patients admitted with pneumonia (43.8 % females) were included in our analysis, with a mean age of 60.7 years and mean APACHE II score of 21.3. During follow-up, 111 patients (16.6 %) died in ICU and in total, 149 (22.3 %) died in hospital. Multivariable analysis demonstrated significant independent risk factors for hospital mortality including male sex (hazard ratio (HR) = 1.5, 95 % confidence interval (CI): 1.1 - 2.2, p-value = 0.021), higher APACHE II score (HR = 1.2, 95 % CI: 1.1 - 1.4, p-value |
| doi_str_mv | 10.1186/s12931-016-0397-5 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4940754</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A458028710</galeid><sourcerecordid>A458028710</sourcerecordid><originalsourceid>FETCH-LOGICAL-c494t-5f6e82fb91f1c78f8bbc3675092852c1c022ceafe9ed556316eb37b8721dd1fe3</originalsourceid><addsrcrecordid>eNptkltrHiEQhqW0NGnaH9CbIvSmN5t6WFe9KYTQEwQCIS29E9cdE9Nd_apuSv59_fjSHErxQhmfeccZX4ReU3JIqRreF8o0px2hQ0e4lp14gvZpP4hOa_7j6YPzHnpRyhUhVCopnqM9JnvSFPp99P0slJ_YW1dTLtinjJeUq51DvcEh4o2tAWIt2E5LqBUmXFOLV4glXAN2NgNeY2jA71Av8SbCuqQY7Ev0zNu5wKvb_QB9-_Tx_PhLd3L6-evx0Unnet3XTvgBFPOjpp46qbwaR8cHKYhmSjBHHWHMgfWgYRJi4HSAkctRSUaniXrgB-jDTnezjgtMrr0129lsclhsvjHJBvP4JoZLc5GuTStPpOibwLtbgZx-rVCqWUJxMM82QlqLoYpwqdtwdUPf_oNepTXH1t6WUoxr1fN76sLOYEL0qdV1W1Fz1AtFmJKUNOrwP1RbEyzBpQg-tPijBLpLcDmVksHf9UiJ2ZrB7MxgmhnM1gxGtJw3D4dzl_H39_kft4KwNA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1808239843</pqid></control><display><type>article</type><title>Risk factors for mortality in patients admitted to intensive care units with pneumonia</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Springer Nature OA/Free Journals</source><source>PubMed Central Open Access</source><creator>Li, Guowei ; Cook, Deborah J ; Thabane, Lehana ; Friedrich, Jan O ; Crozier, Tim M ; Muscedere, John ; Granton, John ; Mehta, Sangeeta ; Reynolds, Steven C ; Lopes, Renato D ; Lauzier, Francois ; Freitag, Andreas P ; Levine, Mitchell A H</creator><creatorcontrib>Li, Guowei ; Cook, Deborah J ; Thabane, Lehana ; Friedrich, Jan O ; Crozier, Tim M ; Muscedere, John ; Granton, John ; Mehta, Sangeeta ; Reynolds, Steven C ; Lopes, Renato D ; Lauzier, Francois ; Freitag, Andreas P ; Levine, Mitchell A H ; PROTECT Investigators for the Canadian Critical Care Trials Group, and the Australian and New Zealand Intensive Care Society Clinical Trials Group ; the PROTECT Investigators for the Canadian Critical Care Trials Group, and the Australian and New Zealand Intensive Care Society Clinical Trials Group</creatorcontrib><description>Despite the high mortality in patients with pneumonia admitted to an ICU, data on risk factors for death remain limited.
In this secondary analysis of PROTECT (Prophylaxis for Thromboembolism in Critical Care Trial), we focused on the patients admitted to ICU with a primary diagnosis of pneumonia. The primary outcome for this study was 90-day hospital mortality and the secondary outcome was 90-day ICU mortality. Cox regression model was conducted to examine the relationship between baseline and time-dependent variables and hospital and ICU mortality.
Six hundred sixty seven patients admitted with pneumonia (43.8 % females) were included in our analysis, with a mean age of 60.7 years and mean APACHE II score of 21.3. During follow-up, 111 patients (16.6 %) died in ICU and in total, 149 (22.3 %) died in hospital. Multivariable analysis demonstrated significant independent risk factors for hospital mortality including male sex (hazard ratio (HR) = 1.5, 95 % confidence interval (CI): 1.1 - 2.2, p-value = 0.021), higher APACHE II score (HR = 1.2, 95 % CI: 1.1 - 1.4, p-value < 0.001 for per-5 point increase), chronic heart failure (HR = 2.9, 95 % CI: 1.6 - 5.4, p-value = 0.001), and dialysis (time-dependent effect: HR = 2.7, 95 % CI: 1.3 - 5.7, p-value = 0.008). Higher APACHE II score (HR = 1.2, 95 % CI: 1.1 - 1.4, p-value = 0.002 for per-5 point increase) and chronic heart failure (HR = 2.6, 95 % CI: 1.3 - 5.0, p-value = 0.004) were significantly related to risk of death in the ICU.
In this study using data from a multicenter thromboprophylaxis trial, we found that male sex, higher APACHE II score on admission, chronic heart failure, and dialysis were independently associated with risk of hospital mortality in patients admitted to ICU with pneumonia. While high illness severity score, presence of a serious comorbidity (heart failure) and need for an advanced life support (dialysis) are not unexpected risk factors of mortality, male sex might necessitate further exploration. More studies are warranted to clarify the effect of these risk factors on survival in critically ill patients admitted to ICU with pneumonia.
ClinicalTrials.gov Identifier: NCT00182143 .</description><identifier>ISSN: 1465-993X</identifier><identifier>ISSN: 1465-9921</identifier><identifier>EISSN: 1465-993X</identifier><identifier>EISSN: 1465-9921</identifier><identifier>DOI: 10.1186/s12931-016-0397-5</identifier><identifier>PMID: 27401184</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Aged ; Aged, 80 and over ; APACHE ; Bacterial pneumonia ; Care and treatment ; Chi-Square Distribution ; Complications and side effects ; Databases, Factual ; Dialysis ; Female ; Heart Failure - mortality ; Hospital Mortality ; Hospitals ; Humans ; Intensive Care Units ; Kaplan-Meier Estimate ; Kidney Diseases - mortality ; Kidney Diseases - therapy ; Male ; Middle Aged ; Mortality ; Multivariate Analysis ; Patient Admission ; Pneumonia ; Pneumonia - diagnosis ; Pneumonia - mortality ; Pneumonia - therapy ; Prophylaxis ; Proportional Hazards Models ; Renal Dialysis - mortality ; Risk Factors ; Secondary analysis ; Services ; Sex Factors ; Thromboembolism ; Time Factors</subject><ispartof>Respiratory research, 2016-07, Vol.17 (1), p.80-80, Article 80</ispartof><rights>COPYRIGHT 2016 BioMed Central Ltd.</rights><rights>Copyright BioMed Central 2016</rights><rights>The Author(s). 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c494t-5f6e82fb91f1c78f8bbc3675092852c1c022ceafe9ed556316eb37b8721dd1fe3</citedby><cites>FETCH-LOGICAL-c494t-5f6e82fb91f1c78f8bbc3675092852c1c022ceafe9ed556316eb37b8721dd1fe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940754/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940754/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27401184$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Guowei</creatorcontrib><creatorcontrib>Cook, Deborah J</creatorcontrib><creatorcontrib>Thabane, Lehana</creatorcontrib><creatorcontrib>Friedrich, Jan O</creatorcontrib><creatorcontrib>Crozier, Tim M</creatorcontrib><creatorcontrib>Muscedere, John</creatorcontrib><creatorcontrib>Granton, John</creatorcontrib><creatorcontrib>Mehta, Sangeeta</creatorcontrib><creatorcontrib>Reynolds, Steven C</creatorcontrib><creatorcontrib>Lopes, Renato D</creatorcontrib><creatorcontrib>Lauzier, Francois</creatorcontrib><creatorcontrib>Freitag, Andreas P</creatorcontrib><creatorcontrib>Levine, Mitchell A H</creatorcontrib><creatorcontrib>PROTECT Investigators for the Canadian Critical Care Trials Group, and the Australian and New Zealand Intensive Care Society Clinical Trials Group</creatorcontrib><creatorcontrib>the PROTECT Investigators for the Canadian Critical Care Trials Group, and the Australian and New Zealand Intensive Care Society Clinical Trials Group</creatorcontrib><title>Risk factors for mortality in patients admitted to intensive care units with pneumonia</title><title>Respiratory research</title><addtitle>Respir Res</addtitle><description>Despite the high mortality in patients with pneumonia admitted to an ICU, data on risk factors for death remain limited.
In this secondary analysis of PROTECT (Prophylaxis for Thromboembolism in Critical Care Trial), we focused on the patients admitted to ICU with a primary diagnosis of pneumonia. The primary outcome for this study was 90-day hospital mortality and the secondary outcome was 90-day ICU mortality. Cox regression model was conducted to examine the relationship between baseline and time-dependent variables and hospital and ICU mortality.
Six hundred sixty seven patients admitted with pneumonia (43.8 % females) were included in our analysis, with a mean age of 60.7 years and mean APACHE II score of 21.3. During follow-up, 111 patients (16.6 %) died in ICU and in total, 149 (22.3 %) died in hospital. Multivariable analysis demonstrated significant independent risk factors for hospital mortality including male sex (hazard ratio (HR) = 1.5, 95 % confidence interval (CI): 1.1 - 2.2, p-value = 0.021), higher APACHE II score (HR = 1.2, 95 % CI: 1.1 - 1.4, p-value < 0.001 for per-5 point increase), chronic heart failure (HR = 2.9, 95 % CI: 1.6 - 5.4, p-value = 0.001), and dialysis (time-dependent effect: HR = 2.7, 95 % CI: 1.3 - 5.7, p-value = 0.008). Higher APACHE II score (HR = 1.2, 95 % CI: 1.1 - 1.4, p-value = 0.002 for per-5 point increase) and chronic heart failure (HR = 2.6, 95 % CI: 1.3 - 5.0, p-value = 0.004) were significantly related to risk of death in the ICU.
In this study using data from a multicenter thromboprophylaxis trial, we found that male sex, higher APACHE II score on admission, chronic heart failure, and dialysis were independently associated with risk of hospital mortality in patients admitted to ICU with pneumonia. While high illness severity score, presence of a serious comorbidity (heart failure) and need for an advanced life support (dialysis) are not unexpected risk factors of mortality, male sex might necessitate further exploration. More studies are warranted to clarify the effect of these risk factors on survival in critically ill patients admitted to ICU with pneumonia.
ClinicalTrials.gov Identifier: NCT00182143 .</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>APACHE</subject><subject>Bacterial pneumonia</subject><subject>Care and treatment</subject><subject>Chi-Square Distribution</subject><subject>Complications and side effects</subject><subject>Databases, Factual</subject><subject>Dialysis</subject><subject>Female</subject><subject>Heart Failure - mortality</subject><subject>Hospital Mortality</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Intensive Care Units</subject><subject>Kaplan-Meier Estimate</subject><subject>Kidney Diseases - mortality</subject><subject>Kidney Diseases - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Patient Admission</subject><subject>Pneumonia</subject><subject>Pneumonia - diagnosis</subject><subject>Pneumonia - mortality</subject><subject>Pneumonia - therapy</subject><subject>Prophylaxis</subject><subject>Proportional Hazards Models</subject><subject>Renal Dialysis - mortality</subject><subject>Risk Factors</subject><subject>Secondary analysis</subject><subject>Services</subject><subject>Sex Factors</subject><subject>Thromboembolism</subject><subject>Time Factors</subject><issn>1465-993X</issn><issn>1465-9921</issn><issn>1465-993X</issn><issn>1465-9921</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNptkltrHiEQhqW0NGnaH9CbIvSmN5t6WFe9KYTQEwQCIS29E9cdE9Nd_apuSv59_fjSHErxQhmfeccZX4ReU3JIqRreF8o0px2hQ0e4lp14gvZpP4hOa_7j6YPzHnpRyhUhVCopnqM9JnvSFPp99P0slJ_YW1dTLtinjJeUq51DvcEh4o2tAWIt2E5LqBUmXFOLV4glXAN2NgNeY2jA71Av8SbCuqQY7Ev0zNu5wKvb_QB9-_Tx_PhLd3L6-evx0Unnet3XTvgBFPOjpp46qbwaR8cHKYhmSjBHHWHMgfWgYRJi4HSAkctRSUaniXrgB-jDTnezjgtMrr0129lsclhsvjHJBvP4JoZLc5GuTStPpOibwLtbgZx-rVCqWUJxMM82QlqLoYpwqdtwdUPf_oNepTXH1t6WUoxr1fN76sLOYEL0qdV1W1Fz1AtFmJKUNOrwP1RbEyzBpQg-tPijBLpLcDmVksHf9UiJ2ZrB7MxgmhnM1gxGtJw3D4dzl_H39_kft4KwNA</recordid><startdate>20160711</startdate><enddate>20160711</enddate><creator>Li, Guowei</creator><creator>Cook, Deborah J</creator><creator>Thabane, Lehana</creator><creator>Friedrich, Jan O</creator><creator>Crozier, Tim M</creator><creator>Muscedere, John</creator><creator>Granton, John</creator><creator>Mehta, Sangeeta</creator><creator>Reynolds, Steven C</creator><creator>Lopes, Renato D</creator><creator>Lauzier, Francois</creator><creator>Freitag, Andreas P</creator><creator>Levine, Mitchell A H</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7U7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160711</creationdate><title>Risk factors for mortality in patients admitted to intensive care units with pneumonia</title><author>Li, Guowei ; Cook, Deborah J ; Thabane, Lehana ; Friedrich, Jan O ; Crozier, Tim M ; Muscedere, John ; Granton, John ; Mehta, Sangeeta ; Reynolds, Steven C ; Lopes, Renato D ; Lauzier, Francois ; Freitag, Andreas P ; Levine, Mitchell A H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c494t-5f6e82fb91f1c78f8bbc3675092852c1c022ceafe9ed556316eb37b8721dd1fe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>APACHE</topic><topic>Bacterial pneumonia</topic><topic>Care and treatment</topic><topic>Chi-Square Distribution</topic><topic>Complications and side effects</topic><topic>Databases, Factual</topic><topic>Dialysis</topic><topic>Female</topic><topic>Heart Failure - mortality</topic><topic>Hospital Mortality</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Intensive Care Units</topic><topic>Kaplan-Meier Estimate</topic><topic>Kidney Diseases - mortality</topic><topic>Kidney Diseases - therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Patient Admission</topic><topic>Pneumonia</topic><topic>Pneumonia - diagnosis</topic><topic>Pneumonia - mortality</topic><topic>Pneumonia - therapy</topic><topic>Prophylaxis</topic><topic>Proportional Hazards Models</topic><topic>Renal Dialysis - mortality</topic><topic>Risk Factors</topic><topic>Secondary analysis</topic><topic>Services</topic><topic>Sex Factors</topic><topic>Thromboembolism</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Guowei</creatorcontrib><creatorcontrib>Cook, Deborah J</creatorcontrib><creatorcontrib>Thabane, Lehana</creatorcontrib><creatorcontrib>Friedrich, Jan O</creatorcontrib><creatorcontrib>Crozier, Tim M</creatorcontrib><creatorcontrib>Muscedere, John</creatorcontrib><creatorcontrib>Granton, John</creatorcontrib><creatorcontrib>Mehta, Sangeeta</creatorcontrib><creatorcontrib>Reynolds, Steven C</creatorcontrib><creatorcontrib>Lopes, Renato D</creatorcontrib><creatorcontrib>Lauzier, Francois</creatorcontrib><creatorcontrib>Freitag, Andreas P</creatorcontrib><creatorcontrib>Levine, Mitchell A H</creatorcontrib><creatorcontrib>PROTECT Investigators for the Canadian Critical Care Trials Group, and the Australian and New Zealand Intensive Care Society Clinical Trials Group</creatorcontrib><creatorcontrib>the PROTECT Investigators for the Canadian Critical Care Trials Group, and the Australian and New Zealand Intensive Care Society Clinical Trials Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Respiratory research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Guowei</au><au>Cook, Deborah J</au><au>Thabane, Lehana</au><au>Friedrich, Jan O</au><au>Crozier, Tim M</au><au>Muscedere, John</au><au>Granton, John</au><au>Mehta, Sangeeta</au><au>Reynolds, Steven C</au><au>Lopes, Renato D</au><au>Lauzier, Francois</au><au>Freitag, Andreas P</au><au>Levine, Mitchell A H</au><aucorp>PROTECT Investigators for the Canadian Critical Care Trials Group, and the Australian and New Zealand Intensive Care Society Clinical Trials Group</aucorp><aucorp>the PROTECT Investigators for the Canadian Critical Care Trials Group, and the Australian and New Zealand Intensive Care Society Clinical Trials Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for mortality in patients admitted to intensive care units with pneumonia</atitle><jtitle>Respiratory research</jtitle><addtitle>Respir Res</addtitle><date>2016-07-11</date><risdate>2016</risdate><volume>17</volume><issue>1</issue><spage>80</spage><epage>80</epage><pages>80-80</pages><artnum>80</artnum><issn>1465-993X</issn><issn>1465-9921</issn><eissn>1465-993X</eissn><eissn>1465-9921</eissn><abstract>Despite the high mortality in patients with pneumonia admitted to an ICU, data on risk factors for death remain limited.
In this secondary analysis of PROTECT (Prophylaxis for Thromboembolism in Critical Care Trial), we focused on the patients admitted to ICU with a primary diagnosis of pneumonia. The primary outcome for this study was 90-day hospital mortality and the secondary outcome was 90-day ICU mortality. Cox regression model was conducted to examine the relationship between baseline and time-dependent variables and hospital and ICU mortality.
Six hundred sixty seven patients admitted with pneumonia (43.8 % females) were included in our analysis, with a mean age of 60.7 years and mean APACHE II score of 21.3. During follow-up, 111 patients (16.6 %) died in ICU and in total, 149 (22.3 %) died in hospital. Multivariable analysis demonstrated significant independent risk factors for hospital mortality including male sex (hazard ratio (HR) = 1.5, 95 % confidence interval (CI): 1.1 - 2.2, p-value = 0.021), higher APACHE II score (HR = 1.2, 95 % CI: 1.1 - 1.4, p-value < 0.001 for per-5 point increase), chronic heart failure (HR = 2.9, 95 % CI: 1.6 - 5.4, p-value = 0.001), and dialysis (time-dependent effect: HR = 2.7, 95 % CI: 1.3 - 5.7, p-value = 0.008). Higher APACHE II score (HR = 1.2, 95 % CI: 1.1 - 1.4, p-value = 0.002 for per-5 point increase) and chronic heart failure (HR = 2.6, 95 % CI: 1.3 - 5.0, p-value = 0.004) were significantly related to risk of death in the ICU.
In this study using data from a multicenter thromboprophylaxis trial, we found that male sex, higher APACHE II score on admission, chronic heart failure, and dialysis were independently associated with risk of hospital mortality in patients admitted to ICU with pneumonia. While high illness severity score, presence of a serious comorbidity (heart failure) and need for an advanced life support (dialysis) are not unexpected risk factors of mortality, male sex might necessitate further exploration. More studies are warranted to clarify the effect of these risk factors on survival in critically ill patients admitted to ICU with pneumonia.
ClinicalTrials.gov Identifier: NCT00182143 .</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>27401184</pmid><doi>10.1186/s12931-016-0397-5</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1465-993X |
| ispartof | Respiratory research, 2016-07, Vol.17 (1), p.80-80, Article 80 |
| issn | 1465-993X 1465-9921 1465-993X 1465-9921 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4940754 |
| source | MEDLINE; Springer Nature - Complete Springer Journals; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Springer Nature OA/Free Journals; PubMed Central Open Access |
| subjects | Aged Aged, 80 and over APACHE Bacterial pneumonia Care and treatment Chi-Square Distribution Complications and side effects Databases, Factual Dialysis Female Heart Failure - mortality Hospital Mortality Hospitals Humans Intensive Care Units Kaplan-Meier Estimate Kidney Diseases - mortality Kidney Diseases - therapy Male Middle Aged Mortality Multivariate Analysis Patient Admission Pneumonia Pneumonia - diagnosis Pneumonia - mortality Pneumonia - therapy Prophylaxis Proportional Hazards Models Renal Dialysis - mortality Risk Factors Secondary analysis Services Sex Factors Thromboembolism Time Factors |
| title | Risk factors for mortality in patients admitted to intensive care units with pneumonia |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-30T18%3A49%3A53IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Risk%20factors%20for%20mortality%20in%20patients%20admitted%20to%20intensive%20care%20units%20with%20pneumonia&rft.jtitle=Respiratory%20research&rft.au=Li,%20Guowei&rft.aucorp=PROTECT%20Investigators%20for%20the%20Canadian%20Critical%20Care%20Trials%20Group,%20and%20the%20Australian%20and%20New%20Zealand%20Intensive%20Care%20Society%20Clinical%20Trials%20Group&rft.date=2016-07-11&rft.volume=17&rft.issue=1&rft.spage=80&rft.epage=80&rft.pages=80-80&rft.artnum=80&rft.issn=1465-993X&rft.eissn=1465-993X&rft_id=info:doi/10.1186/s12931-016-0397-5&rft_dat=%3Cgale_pubme%3EA458028710%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1808239843&rft_id=info:pmid/27401184&rft_galeid=A458028710&rfr_iscdi=true |