Comorbidities impact on the prognosis of severe acute community-acquired pneumonia

Vidal, A.K.L Lacerda; Santos, Lurdes

doi:10.1016/j.pbj.2017.04.009

Cited by 33 publications

(24 citation statements)

References 30 publications

(59 reference statements)

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“…[1] A higher APACHE II score at ICU admission, male sex, chronic heart failure and dialysis were identified as independent risk factors for in-hospital mortality in a study by Li et al [21] An association between mortality and underlying chronic lung diseases is well described in the literature. Vidal et al [22] identified a 23% mortality in patients with CAP and comorbid chronic respiratory disease in a study conducted in Portugal. A retrospective cohort study in the USA showed a statistically significant increase in 30-day mortality, rate of ICU admission and length of hospital stay among patients with co-existing COPD who were hospitalised for CAP.…”

Section: Discussionmentioning

confidence: 99%

The aetiology of severe community-acquired pneumonia requiring intensive care unit admission in the Western Cape

Mazaza

Lalla

Taljaard

et al. 2020

Afr J Thorac Crit Care Med

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Background. Community-acquired pneumonia (CAP) is a common condition, with mortality increasing in patients who require intensive care unit (ICU) admission. A better understanding of the current aetiology of severe CAP will aid clinicians in requesting appropriate diagnostic tests and initiating appropriate empiric antimicrobials. Objective. To assess the comorbidities, aetiology and mortality associated with severe CAP in a tertiary ICU in Cape Town, South Africa. Methods. We retrospectively analysed a prospective registry of all adults admitted to the medical intensive care unit at Tygerberg Hospital with severe CAP over a 1-year period. Results. We identified 74 patients (mean (SD) age 40.0 (15.5) years; 44 females). The patients had a mean (SD) APACHE II score of 21.4 (7.9), and the mean ICU stay was 6.6 days. Of the 74 patients, 16 (21.6%) died in ICU. Non-survivors had a higher mean (SD) APACHE II score than survivors (28.3 (6.8) v. 19.4 (7.1); p<0.001). Mycobacterium tuberculosis (n=16; 21.6%) was the single most common agent identified, followed by Pseudomonas aeruginosa (n=9; 12.2%). All P. aeruginosa isolates were sensitive to first-line treatment. No organism was identified in 32 patients (43.2%). Conclusion. M. tuberculosis was the single most common agent identified in patients presenting with CAP. The mortality of CAP requiring invasive ventilation was relatively low, with a strong association between mortality and a higher APACHE II score.

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Section: Discussionmentioning

confidence: 99%

The aetiology of severe community-acquired pneumonia requiring intensive care unit admission in the Western Cape

Mazaza

Lalla

Taljaard

et al. 2020

Afr J Thorac Crit Care Med

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“…First of all, the commonality of the disease mechanisms and the equivalence of therapeutic efforts, rather than the nature of the pathogens of the process, determine the final results. In this regard, it is quite natural that the mortality rates from bacterial forms of AP (30-50%) in recent years among patients in intensive care units (17)(18)(19)(20)(21) are identical to this current indicator for COVID-19 (22)(23)(24)(25).…”

Section: Sixth the Underestimation Of Causal Relationships In The Pathogenesis Of Ap Ismentioning

confidence: 93%

Look at the COVID-19 Pandemic with an Open Mind

2021

AHS

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Our assessment of various events and phenomena depends, first of all, on our baggage of acquired knowledge, established stereotypes and worldviews. It is this kind of bias that affects the definition of our goals, decisions and specific actions, which often go against the observed facts and lose sight of important features of the object being studied. The way experts perceive the current COVID-19 pandemic is one typical example of such a biased interpretation. The basis of the clinical picture of coronavirus infection is a lesion of the lung tissue, which, according to clinical and radiological and pathoanatomical data, is defined as viral inflammation and corresponds to the nosology "acute pneumonia" (AP)(1-4). According to the modern concept of AP, the only and main cause of this disease is considered to be its causative agent. This view of the nature of the AP is generally consistent with current events. Indeed, coronavirus infection causes inflammation of the lung tissue. At the same time, the usual treatment of AP with etiotropic drugs is unattainable in coronavirus infection due to the lack of such drugs.

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“…The most severe patients with AP are concentrated in Intensive Care Units (ICU), where the majority of deaths are recorded. Currently, when the material on monitoring and supporting care (rather than treatment) for patients with COVID-19 pneumonia is accumulated, the results show that the mortality rates in this group do not differ from this indicator for bacterial forms of pneumonia -up to 30-50% (16)(17)(18)(19)(20)(21)(22)(23)(24). The difference is that with bacterial infl ammation, everyone was sure that the patients received adequate care.…”

mentioning

confidence: 99%

Psychoanalysis of the doctrine of acute pneumonia

Klepikov¹

2021

Arch Pulmonol Respir Care

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Comorbidities impact on the prognosis of severe acute community-acquired pneumonia

Cited by 33 publications

References 30 publications

The aetiology of severe community-acquired pneumonia requiring intensive care unit admission in the Western Cape

The aetiology of severe community-acquired pneumonia requiring intensive care unit admission in the Western Cape

Look at the COVID-19 Pandemic with an Open Mind

Psychoanalysis of the doctrine of acute pneumonia

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