PURPOSE:Between 20% and 50% of patients with community acquired pneumonia (CAP) will develop a parapneumonic effusion (PPE). The impact of a PPE on the clinical outcomes of hospitalized patients with CAP has not been fully evaluated. The aim of this study is to identify the effect of a PPE on four relevant outcomes of CAP.
METHODS:A secondary analysis was conducted of the Community-Acquired Pneumonia Organization (CAPO) database, which contains retrospectively collected data on patients with CAP from 43 hospitals in 12 countries from June 2001 to May 2007. PPE was defined as an accumulation of fluid on chest radiograph that develops during pneumonia. CAP clinical outcomes, length of stay (LOS), time to clinical stability (TCS), and failure were defined by IDSA/ATS guidelines. In-hospital mortality was defined as death during hospitalization. The logistic regression model was used to predict the probability of occurrence of outcomes for PPE.
RESULTS:A total of 3070 patients were included in the study. The mean ±SD age was 66 ±18 years (range: 18–102) and 38% were female. PPE was found in 554 (18%) patients. The effect of PPE on CAP clinical outcomes is shown in the following table.
CONCLUSION:This study shows that patients with a PPE have poor outcomes during hospitalization for CAP.
CLINICAL IMPLICATIONS:Further research is needed to evaluate physician compliance with current PPE treatment guidelines and if more aggressive management of PPE may improve clinical outcomes.
DISCLOSURE:Ervin Anaya, No Financial Disclosure Information; No Product/Research Disclosure Information