Table 38-1.

Risk Factors for Developing Severe Community-Acquired Pneumonia

•Advanced age (>65 yr) • Comorbid illness: especially if decompensated • Chronic respiratory illness (including chronic obstructive pulmonary disease), cardiovascular disease, diabetes mellitus, neurologic illness, renal insufficiency, malignancy •Cigarette smoking (risk for pneumococcal bacteremia) •Alcohol abuse •Absence of antibiotic therapy before hospitalization, or inappropriate therapy •Residence in a chronic care facility •Poor functional status •Failure to contain infection to its initial site of entry •Immune suppression (corticosteroids, other illnesses) •Genetic polymorphisms in the immune response