PMID: 13677877Sep 19, 2003

Prognosis of severe community-acquired pneumonia in alcoholic patients hospitalized in intensive care

La Presse médicale
J CunyF Lambiotte

Abstract

The purpose of our study was to determine prognosis factors of alcoholic patients hospitalised in an intensive care unit with severe community-acquired pneumonia (SCAP). Chronic alcoholism was defined by intake of pur alcohol more than 36 g per day for more than one year and severe community-acquired pneumonia by the criteria of the American Thoracic Society. 50 patients were included. Mortality rate was 48% in the department and 68% at two months after dismissal from intensive care. 1 Yen percent of patients were admitted in a state of shock (100% mortality). The most frequent pathogen was Streptococus pneumoniae (38%). The major complications were: 24% acute respiratory distress syndrome (ARDS), 18% multi-organ failure, 48% disseminated intravascular coagulopathy (DIC), 48% pulmonary superinfection. Antibiotherapy was not conform to current guidelines in 20% of cases and hence led to 90% death. Mortality rate was higher than in other studies. Bad prognosis factors were identified: severe state on admission, shock on admission or subsequently, non adapted initial antibiotherapy, Child's score B and C, Streptococus pneumoniae, complications: ARDS, superinfections, coagulopathy, multi organ failure.

Related Concepts

Alcohol Abuse
Bacteriocidal Agents
Disseminated Intravascular Coagulation
Intensive Care Unit
Multiple Organ Failure
Pneumococcal Infections
Experimental Lung Inflammation
Respiratory Distress Syndrome, Adult
Community-Acquired Infections

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