Table 1.
Baseline characteristics, behavior during ICU stay, and outcome of 174 patients with severe CAP, according to the microbiological diagnosis
| Patients | All patients (n = 174) |
Bacterial group (n = 46) |
Viral group (n = 53) |
Mixed group (n = 45) |
No etiology group (n = 30) |
p valuea |
|---|---|---|---|---|---|---|
| Age, y | 63 [53;75] | 64 [53;75] | 64 [54;75] | 63 [54;75] | 66 [57;78] | 0.85 |
| Sex, male | 132 (75.9) | 37 (80.4) | 38 (71.7) | 33 (73.3) | 24 (80) | 0.69 |
| Weight, kg | 71 [62;82] | 70 [60;80] | 71 [64;84] | 70 [60;77] | 75 [62;83] | 0.64 |
| Smoking | 53 (31.7) | 16 (37.2) | 16 (30.8) | 13 (30.2) | 8 (27.6) | 0.83 |
| McCabe score > 1 | 38 (21.8) | 7 (15.2) | 13 (24.5) | 12 (26.7) | 6 (20) | 0.56 |
| WHO performance status > 0 | 53 (33.5) | 10 (22.7) | 19 (41.3) | 14 (35.9) | 10 (34.5) | 0.30 |
| Chronic immunosuppression | 57 (32.8) | 16 (34.8) | 21 (39.6) | 14 (31.1) | 6 (20) | 0.32 |
| HIV | 14 (8) | 7 (15.2) | 3 (5.7) | 3 (6.7) | 1 (3.3) | 0.20 |
| Steroid therapy | 19 (10.9) | 2 (4.3) | 10 (18.9) | 6 (13.3) | 1 (3.3) | 0.06 |
| Other immunosuppressive | 21 (12.4) | 3 (6.5) | 10 (20) | 7 (15.6) | 1 (3.4) | 0.08 |
| Solid organ transplantation | 14 (8) | 2 (4.3) | 5 (9.4) | 6 (13.3) | 1 (3.3) | 0.31 |
| Cancer | 15 (8.6) | 6 (13) | 4 (7.5) | 2 (4.4) | 3 (10) | 0.51 |
| Chronic diseaseb | 86 (49.4) | 20 (43.5) | 34 (64.2) | 20 (44.4) | 12 (40) | 0.08 |
| Coronary artery disease | 27 (15.5) | 6 (13) | 9 (17) | 9 (20) | 3 (10) | 0.64 |
| HCAPc | 86 (49.4) | 22 (47.8) | 31 (58.5) | 22 (48.9) | 11 (36.7) | 0.29 |
| Transfer from another wardd | 58 (33.3) | 14 (30.4) | 19 (35.8) | 17 (37.8) | 8 (26.7) | 0.72 |
| Antibiotics before ICU admissione | 77 (44.3) | 15 (32.6) | 30 (56.6) | 19 (42.2) | 13 (43.3) | 0.12 |
| Organ failures on ICU admission | ||||||
| Glasgow < 15 | 42 (24.1) | 14 (30.4) | 11 (20.8) | 11 (24.4) | 6 (20) | 0.66 |
| Shock | 32 (18.4) | 14 (30.4) | 3 (5.7) | 11 (24.4) | 4 (13.3) | <0.01 |
| PaO2/FIO2 ratio | 174 [130;230] | 173 [130;229] | 172 [122;227] | 165 [134;228] | 200 [165;252] | 0.22 |
| SAPS II score | 38 [27;55] | 39 [32;60] | 36 [26;48] | 46 [34;59] | 33 [18;46] | 0.02 |
| PSI score at hospital referral | 106 [78;130] | 110 [84;152] | 98 [82;128] | 119 [98;126] | 89 [70;121] | 0.12 |
| PSI class IV-V at hospital referral | 114 (65.5) | 31 (67.4) | 33 (62.3) | 36 (80) | 14 (46.7) | 0.03 |
| Organ supports during ICU stay | ||||||
| Noninvasive ventilation | 55 (31.8) | 14 (30.4) | 21 (40.4) | 12 (26.7) | 8 (26.7) | 0.44 |
| Mechanical ventilation | 98 (56.3) | 28 (60.9) | 22 (41.5) | 36 (80) | 12 (40) | <0.01 |
| ARDS | 60 (34.5) | 17 (37) | 13 (24.5) | 22 (48.9) | 8 (26.7) | 0.06 |
| Dialysis | 37 (21.3) | 10 (21.7) | 10 (18.9) | 12 (26.7) | 5 (16.7) | 0.72 |
| Vasopressors | 80 (46.2) | 22 (47.8) | 19 (36.5) | 27 (60) | 12 (40) | 0.12 |
| Outcome | ||||||
| Length of mechanical ventilation, d | 9 [5;13] | 6.5 [3;12.5] | 7 [4;12] | 9 [6;14] | 10 [7.5;17.5] | 0.34 |
| Follow-up duration, df | 15 [10 ; 29] | 14 [5;23] | 18 [12;32] | 16 [11;31] | 14.5 [12;19] | 0.25 |
| Hospital mortality | 30 (17.2) | 6 (13) | 6 (11.3) | 13 (28.9) | 5 (16.7) | 0.10 |
| Complicated courseg | 74 (42.5) | 18 (39.1) | 15 (28.3) | 31 (68.9) | 10 (33.3) | <0.01 |
Data are presented as median [first through third quartiles] or number (%)
ARDS acute respiratory distress syndrome, CAP community-acquired pneumonia; HCAP health care-associated pneumonia, HIV human immunodeficiency virus, ICU intensive care unit, PSI Pneumonia Severity Index, SAPS Simplified Acute Physiologic Score, WHO World Health Organization.
a p values refer to differences between bacterial, viral, mixed, and no etiology groups in univariate logistic regression
bChronic disease included chronic dialysis, mellitus diabetes requiring oral medication and/or insulin, chronic heart failure classified NYHA 3 or 4, cirrhosis, chronic respiratory failure requiring long-term oxygen therapy, and chronic immunosuppression
cPneumonia was considered health care-associated (HCAP) in the presence of at least one of the following conditions: hospitalization for ≥ 2 days in the preceding 90 days, institutionalization, chronic dialysis, and chronic immunosuppression
dTransfer from another ward included transfers from another ICU and from the medical wards
eAntibiotics before ICU admission referred to any administration of antibiotics, whatever drug regimen, before the ICU referral, i.e., in emergency departments or in other medical wards
fThe follow-up duration was defined as the time between the date of the mPCR and the date of hospital discharge. If the patient was deceased in hospital, the date of death was considered hospital discharge. If the patient was not deceased in hospital and the date of hospital discharge was not available, the date of ICU discharge was considered hospital discharge gComplicated course was defined as hospital death and/or mechanical ventilation > 7 days