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• W1973453028 abstract "En Chile existe escasa información acerca de la neumonía adquirida en la comunidad de carácter grave manejada en las unidades de cuidados intensivos. En este trabajo se describen el cuadro clínico, los factores pronósticos y el tratamiento de pacientes adultos hospitalizados en la unidad de cuidados intensivos por neumonía adquirida en la comunidad grave. Se ha realizado un estudio clínico prospectivo y descriptivo que ha incluido a 113 pacientes consecutivos. De los 113 pacientes incluidos (edad media ± desviación estándar: 73 ± 15 años), el 95% tenía comorbilidad asociada y un 81% pertenecía a las categorías de alto riesgo del índice de gravedad de la neumonía (Pneumonia Severity Index). Se demostró la etiología en el 31% y los patógenos más frecuentes fueron Streptococcus pneumoniae (40%), bacilos gramnegativos (17%) y Mycoplasma pneumoniae (6%). Las principales complicaciones fueron necesidad de ventilación mecánica (45%), shock séptico (26%), insuficiencia cardíaca (24%) y arritmias (15%). La mortalidad a los 30 días fue del 16,8% y mediante un análisis multivariado se identificaron los siguientes factores asociados a mayor riesgo de muerte: insuficiencia renal aguda (odds ratio = 5,1) y glucemia mayor de 300 mg/dl (odds ratio = 7,2). Los pacientes con neumonía grave ingresados en la unidad de cuidados intensivos son de edad avanzada, con una alta tasa de comorbilidad y complicaciones, pero la mayoría sobrevive. In Chile very little information is available on severe community-acquired pneumonia treated in intensive care units. This study describes the clinical picture, prognostic factors, and treatment of adult patients admitted to the intensive care unit for severe community-acquired pneumonia. A total of 113 consecutive patients were included in this prospective, descriptive study. The mean (SD) age of the 113 patients was 73 (15). Of these, 95% had associated comorbidity, and 81% were in the high-risk classes of the Pneumonia Severity Index. Etiology was identified in 31%, and the most common pathogens were Streptococcus pneumoniae (40%), gram negative bacilli (17%), and Mycoplasma pneumoniae (6%). The main complications were the need for mechanical ventilation (45%), septic shock (26%), heart failure (24%), and arrhythmias (15%). Mortality at 30 days was 16.8%, and multivariate analysis revealed the following factors to be associated with a greater risk of death: acute renal failure (odds ratio: 5.1), and glycemia above 300 mg/dL (odds ratio: 7.2). The patients with severe pneumonia admitted to the intensive care unit are elderly, with a high level of comorbidity and complications, but most survive." @default.
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• W1973453028 date "2005-02-01" @default.
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• W1973453028 title "Cuadro clínico y factores pronósticos de la neumonía adquirida en la comunidad grave en adultos hospitalizados en la unidad de cuidados intensivos" @default.
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