期刊
EUROPEAN RESPIRATORY JOURNAL
卷 39, 期 4, 页码 963-970出版社
EUROPEAN RESPIRATORY SOC JOURNALS LTD
DOI: 10.1183/09031936.00076911
关键词
Community-acquired pneumonia; Legionella pneumophila; mortality; outcomes; risk factors
资金
- National Institute for Public Health Surveillance (Institut de Veille Sanitaire)
- French College of Infectious and Tropical Diseases (College des Universitaires de Maladies Infectieuses et Tropicales)
- French Society for Infectious Diseases (Societe de Pathologie Infectieuse de Langue Francaise)
The aims of this study were to describe the clinical, biological and radiological features of community-acquired (CA) Legionnaires' disease (LD) and identify the predictors of mortality in hospitalised patients. Demographic data, risk factors, clinical and biological features, medical management, complications, and outcome from 540 hospitalised patients with confirmed CA LD were prospectively recorded. 8.1% of patients (44 out of 540) died. The predictors of survival after Kaplan-Meier analysis were male sex (p=0.01), age <60 yrs (p=0.02), general symptoms (p=0.006), intensive care unit (ICU) stay (p<0.001), and class II-III Pneumonia Severity Index score (p=0.004). Six predictors of death were identified by multivariate analysis: age (per 10-yr increment) (relative hazard (RH) 1.50, 95% CI 1.21-1.87), female sex (RH 2.00, 95% CI 1.08-3.69), ICU admission (RH 3.31, 95% CI 1.67-6.56), renal failure (RH 2.73, 95% CI 1.42-5.27), corticosteroid therapy (RH 2.54, 95% CI 1.04-6.20) and C-reactive protein (CRP).500 mg.L-1 (RH 2.14, 95% CI 1.02-4.48). Appropriate antibiotic therapy was prescribed for 70.8% (292 out of 412) of patients after admission and for 99.8% (537 out of 538) of patients after diagnosis confirmation. In conclusion, female sex, age, ICU stay, renal failure, corticosteroid treatment and increased level of CRP are significant risk factors for mortality in CA LD.
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