Intensive Care Medicine

, Volume 15, Issue 5, pp 302–307

Community-acquired pneumonia of diverse aetiology: prognostic features in patients admitted to an intensive care unit and a “severity of illness” score

  • C. Feldman
  • J. M. Kallenbach
  • H. Levy
  • S. G. Reinach
  • M. D. Hurwitz
  • J. R. Thorburn
  • H. J. Koornhof
Original Articles

Abstract

In a retrospective study of 73 patients with community-acquired lobar pneumonia of diverse aetiology admitted to an intensive care unit, an attempt was made to identify those factors among the demographic and clinical features and results of initial laboratory investigations that were predictive of the ultimate outcome. A lower mean white cell count (p=0.03), platelet count (p=0.02), total serum protein (p=0.005) and albumin (p=0.02) and a higher mean serum creatinine (p=0.03) and phosphate level (p=0.02) appeared to be predictive of a poor prognosis. The most significant variable predictive of mortality, was the presence of bacteraemia (p=0.0005). Severity of illness scoring systems by omitting microbiological data appear to underestimate predicted patient mortality. The mortality rate of critically ill patients with community-acquired lobar pneumonia remains high, despite advances in antimicrobial chemotherapy and intensive care unit facilities, particularly in the presence of certain negative prognostic factors of which the presence of bacteraemia is the most important.

Key words

Community-acquired lobar pneumonia Intensive care unit Bacteraemia 

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Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • C. Feldman
    • 1
    • 2
  • J. M. Kallenbach
    • 1
    • 2
  • H. Levy
    • 1
    • 2
  • S. G. Reinach
    • 4
  • M. D. Hurwitz
    • 1
    • 2
  • J. R. Thorburn
    • 1
    • 2
  • H. J. Koornhof
    • 3
  1. 1.Department of Medicine and AnaesthesiaHillbrow HospitalJohannesburgSouth Africa
  2. 2.University of the WitwatersrandJohannesburgSouth Africa
  3. 3.Department of Medical Microbiology, School of PathologySouth Africa Institute of Medical ResearchJohannesburgSouth Africa
  4. 4.Institute of Biostatistics of the South African Medical Research CouncilJohannesburgSouth Africa

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