Source:http://linkedlifedata.com/resource/pubmed/id/21071473
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
6
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| pubmed:dateCreated |
2011-6-2
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| pubmed:abstractText |
Long-term outcomes in patients surviving community-acquired pneumonia (CAP) are still incompletely understood. This study investigates the association of clinical parameters and blood markers with long-term mortality. We prospectively followed 877 CAP patients from a previous multicentre trial for 18 months follow-up and investigated all-cause mortality following hospital discharge. Overall mortality was 17.3% (95% CI 14.8-19.8%) with a 12.8% (95% CI 10.9-15.0%) mortality incidence rate per year. Initial risk assignment using the Pneumonia Severity Index was accurate during the 18 month follow-up. Multivariable regression models (hazard ratio, 95% CI) designated the following as independent risk factors for long-term mortality: male sex (1.7, 1.2-2.5); chronic obstructive pulmonary disease (1.5, 1.1-2.1); neoplastic disease (2.5, 1.7-3.7); and highest quartile of peak pro-adrenomedullin level (3.3, 1.7-6.2). Initial presentation with temperature>38.7°C (0.4, 0.2-0.6), chills (0.6, 0.4-0.99) and highest quartile of the inflammatory marker C-reactive-protein (0.3, 0.2-0.5) were independent protective factors. A weighted risk score based on these variables showed good discrimination (area under receiver operating characteristic curve 0.78, 95% CI 0.74-0.82). Pronounced clinical and laboratory signs of systemic inflammatory host response upon initial hospital stay were associated with favourable long-term prognosis. Further studies should address whether closer monitoring of high-risk CAP patients after hospital discharge favourably impacts long-term mortality.
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| pubmed:commentsCorrections | |
| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
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| pubmed:chemical | |
| pubmed:status |
MEDLINE
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| pubmed:month |
Jun
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| pubmed:issn |
1399-3003
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| pubmed:author | |
| pubmed:issnType |
Electronic
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| pubmed:volume |
37
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| pubmed:owner |
NLM
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| pubmed:authorsComplete |
Y
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| pubmed:pagination |
1439-46
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| pubmed:meshHeading |
pubmed-meshheading:21071473-Adrenomedullin,
pubmed-meshheading:21071473-Aged,
pubmed-meshheading:21071473-Aged, 80 and over,
pubmed-meshheading:21071473-C-Reactive Protein,
pubmed-meshheading:21071473-Chills,
pubmed-meshheading:21071473-Community-Acquired Infections,
pubmed-meshheading:21071473-Female,
pubmed-meshheading:21071473-Fever,
pubmed-meshheading:21071473-Humans,
pubmed-meshheading:21071473-Inflammation,
pubmed-meshheading:21071473-Male,
pubmed-meshheading:21071473-Middle Aged,
pubmed-meshheading:21071473-Neoplasms,
pubmed-meshheading:21071473-Pneumonia,
pubmed-meshheading:21071473-Prognosis,
pubmed-meshheading:21071473-Prospective Studies,
pubmed-meshheading:21071473-Protein Precursors,
pubmed-meshheading:21071473-Pulmonary Disease, Chronic Obstructive,
pubmed-meshheading:21071473-Risk,
pubmed-meshheading:21071473-Severity of Illness Index,
pubmed-meshheading:21071473-Sex Factors,
pubmed-meshheading:21071473-Treatment Outcome
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| pubmed:year |
2011
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| pubmed:articleTitle |
Inflammatory responses predict long-term mortality risk in community-acquired pneumonia.
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| pubmed:affiliation |
Department of Internal Medicine, University Hospital Basel, Basel, Switzerland.
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| pubmed:publicationType |
Journal Article
|