Prognosis and Outcomes of Patients With Community-Acquired Pneumonia

Fine, Michael J.; Smith, Melanie A.; Carson, Catherine A.; Mutha, Sunita; Sankey, Steadman S.; Weissfeld, Lisa A.; Kapoor, Wishwa N.

doi:10.1001/jama.1996.03530260048030

Cited by 1,014 publications

(324 citation statements)

References 106 publications

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“…Mortality is estimated to be <1% among non-hospitalized patients [2,3]. However, the mortality rate rises dramatically among patients requiring hospitalization, especially among those who need intensive care.…”

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confidence: 99%

An open label, multicenter, non-comparative study of the efficacy and safety of oral gatifloxacin in the treatment of community-acquired pneumonia: a Brazilian study in five centers

Nicodemo¹

2003

Braz J Infect Dis

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We made an open label, multicenter, non-comparative study to assess the efficacy and safety of oral gatifloxacin, 400mg PO given once-daily during 7 to 14 days for the treatment of adult outpatients with community-acquired pneumonia at five Brazilian medical facilities. Among the 86 subjects available for clinical evaluation, 84 (98%) were cured. The bacteriological eradication and presumed eradication rate was 98% (52/53) among the 44 (51%) patients who were bacteriologically evaluated. Drug-related adverse events were reported by 27% of the patients, diarrhea being the most frequent, occurring in 12% of patients. Adverse events were considered mild (89%) or moderate (11%). We conclude that a 7-14 day course of gatifloxacin, 400mg PO given once daily is safe and effective for the treatment of community-acquired pneumonia. The drug had a favorable safety profile and a good clinical and bacteriological efficacy.

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confidence: 99%

An open label, multicenter, non-comparative study of the efficacy and safety of oral gatifloxacin in the treatment of community-acquired pneumonia: a Brazilian study in five centers

Nicodemo¹

2003

Braz J Infect Dis

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“…revious studies of outcomes in patients with community-acquired pneumonia have focused primarily on early mortality following pneumonia in comparing outcomes across different patient groups, microbiologic etiologies, or types of care. [1][2][3][4] However, there is growing appreciation that for most patients with pneumonia, especially those at very low risk of dying, the time course of symptomatic and functional recovery is also of great importance. 5 …”

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confidence: 99%

“…[1][2][3][4] However, there is growing appreciation that for most patients with pneumonia, especially those at very low risk of dying, the time course of symptomatic and functional recovery is also of great importance. 5 …”

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confidence: 99%

Measuring symptomatic and functional recovery in patients with community-acquired pneumonia

et al. 1997

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OBJECTIVE:To determine the rates of resolution of symptoms and return to premorbid health status and assess the association of these outcomes with health care utilization in patients with community-acquired pneumonia. DESIGN:A prospective, multicenter cohort study.SETTING: Inpatient and outpatient facilities at three university hospitals, one community hospital, and one staff-model health maintenance organization. PATIENTS:Five hundred seventy-six adults (aged Ն 18 years) with clinical and radiographic evidence of pneumonia, judged by a validated pneumonia severity index to be at low risk of dying. MEASUREMENTS AND MAIN RESULTS:The presence and severity of five symptoms (cough, fatigue, dyspnea, sputum, and chest pain) were recorded through questionnaires administered at four time points: 0, 7, 30, and 90 days from the time of radiographic diagnosis of pneumonia. A summary symptom score was tabulated as the sum of the five individual severity scores. Patients also provided responses to the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and reported the number of and reason for outpatient physician visits. Symptoms and health status 30 days before pneumonia onset (prepneumonia) were obtained at the initial interview. All symptoms, except pleuritic chest pain, were still commonly reported at 30 days, and the prevalence of each symptom at 90 days was still nearly twice prepneumonia levels. Physical health measures derived from the SF-36 Form declined significantly at presentation but continued to improve over all three follow-up time periods. Patients with elevated symptom scores at day 7 or day 30 were significantly more likely to report pneumonia-related ambulatory care visits at the subsequent day 30 or day 90 interviews, respectively.CONCLUSIONS: Disease-specific symptom resolution and recovery of the premorbid physical health status requires more than 30 days for many patients with pneumonia. Delayed resolution of symptoms is associated with increased utilization of outpatient physician visits.

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“…Las variables clínicas y de laboratorio medidas en la admisión al hospital asociadas a mayor riesgo de complicaciones y muerte en el seguimiento a corto plazo (letalidad en el hospital o seguimiento a 30 días) han sido claramente definidas [3][4][5][6] . En un meta-análisis que incluyó 122 estudios clínicos, los principales factores pronósticos en el seguimiento a corto plazo fueron la edad avanzada (mayor de 65 años), las comorbilidades, especialmente cardiovascular, metabólica, respiratoria y neurológica crónica, las neoplasias e inmunosupresión y la gravedad de la infección en la admisión al hospital o la unidad de cuidados intensivos 7 . La evaluación de la gravedad basados en variables clínicas objetivas o índices pronósticos como el índice de gravedad de la neumonía 8 y el CURB-65 9 ha permitido a los clínicos decidir el lugar de manejo de los enfermos, la extensión del estudio microbiológico y de laboratorio, el tratamiento antimicrobiano, la ruta y vía de administración [10][11][12] .…”

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Sobrevida a largo plazo en adultos inmunocompetentes mayores de 60 años hospitalizados por neumonía adquirida en la comunidad

et al. 2013

Rev. méd. Chile

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Prognosis and Outcomes of Patients With Community-Acquired Pneumonia

Cited by 1,014 publications

References 106 publications

An open label, multicenter, non-comparative study of the efficacy and safety of oral gatifloxacin in the treatment of community-acquired pneumonia: a Brazilian study in five centers

An open label, multicenter, non-comparative study of the efficacy and safety of oral gatifloxacin in the treatment of community-acquired pneumonia: a Brazilian study in five centers

Measuring symptomatic and functional recovery in patients with community-acquired pneumonia

Sobrevida a largo plazo en adultos inmunocompetentes mayores de 60 años hospitalizados por neumonía adquirida en la comunidad

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