Severe community-acquired pneumonia in an intensive care unit: Risk factors for mortality
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概要
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Objective: To evaluate severe community-acquired pneumonia (SCAP) patients in an intensive care unit (ICU) with regard to risk factors for mortality and to compare ICU patients with matched non-ICU patients to evaluate whether our judgement for ICU admission was appropriate or not. Materials and methods: During a 7-year period, all patients with CAP who were admitted to the ICU were examined. They underwent clinical and radiographic evaluations, and two commonly used severity of illness scores were also calculated using the Simplified Acute Physiological Score (SAPS) and the Acute Physiology and Chronic Health Evaluation (APACHE) II methods. To detect risk factors for ICU admission using existing guidelines, each study patient was matched with two patients hospitalized in a general medical ward. Results: Seventy-two patients were identified during the study period. Their mean age was 72.9 years, and 35 patients (48.6%) subsequently died. For the univariate analysis, there were significant differences with the pulse rate ≥130/min, blood urea nitrogen ≥30 mg/dl, multilobar shadow, SAPS ≥43, APACHE II ≥23, and the occurrence of septic shock between the survivors and those who died. For the multivariate analysis, septic shock (p=0.0005, odds ratio of 26.6) and blood urea nitrogen ≥30 mg/dl (p=0.037, odds ratio of 5.38) were associated with mortality. Regarding the characteristics of different clinical predictions for ICU admission, the revised American Thoracic Society criteria might have been the most accurate. Conclusion: Septic shock was associated with high mortality, which is a more accurate and higher predictor of mortality than was physical examination, laboratory or radiographic findings.
- 日本内科学会 = the Japanese Society of Internal Medicineの論文
- 2005-07-01
著者
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NAKAMURA Hiroyuki
Department of Materials Science and Engineering, Kyoto University
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中尾 眞二
Cellular Transplantation Biology Kanazawa University Graduate School Of Medical Science
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Nakao Shinji
日本医科大学 第三内科
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NAKAO Shinji
Department of Cellular Transplantation Biology, Graduate School of Medical Sciences, Kanazawa Univer
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YOSHIMOTO Akihiro
Department of Internal Medicine, Kurobe City Hospital
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Fujimura Masaki
Department of Respiratory Medicine, Cellular Transplantation Biology, Kanazawa University Graduate S
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Sahara Naohi
浜松医科大学 内科学第3
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Fujimura Masaki
Cellular Transplantation Biology Department Of Respiratory Medicine Kanazawa University Graduate Sch
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Fujimura Masaki
Department Of Obstrics And Gvnecology Toyama Medical And Pharmaceutical University
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Fujimura Masaki
Department Of Internal Medicine Fukui Cardiovascular Center
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Nakao Shinji
Department Of Cellular Transplantation Biology Kanazawa University Graduate School Of Medical Scienc
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Nakao Shinji
Department Of Hematology Kanazawa University Graduate School Of Medical Science
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Nakao Shinji
Cellular Transplantation Biology Department Of Respiratory Medicine Kanazawa University Graduate Sch
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Nakamura Hiroyuki
Department Of Dermatology Hokkaido University Graduate School Of Medicine
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Fujimura Masaki
Third Department Of Internal Medicine Kanazawa University School Of Medicine
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Yoshimoto Akihiro
Department Of Haematology-oncology And Respiratory Medicine Cellular Transplantation Biology Kanazaw
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Fujimura Masaki
Department Of Gynecology Saitama Cancer Center
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Nakamura Hiroyuki
Department Of Chemistry Graduate School Of Science Tohoku University
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Nakamura Hiroyuki
Department Of Biochemistry Osaka Medical Center For Cancer And Cardiovascular Diseases
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Fujimura Masaki
Pulmonary Medicine Cellular Transplantation Biology Kanazawa University Graduate School Of Medicine
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Nakamura Hiroyuki
Department Of Internal Medicine Toyama City Hospital
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Yoshimoto Akihiro
Department Of Cardiovascular Surgery Gunma Children's Medical Center
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Yoshimoto Akihiro
Department Of Applied Biochemistry Faculty Of Applied Biological Science Hiroshima University
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Nakamura Hiroyuki
Department of Advanced Materials, University of Tokyo, Kashiwa, Chiba 277-8561
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