Although pneumonia has been identified as the single most common risk factor for Acute lung injury (ALI) we currently have a very limited understanding of the relationship between specific causative organisms and development of ALI.
In a retrospective cohort study we reviewed medical records of patients with microbiologically positive pneumonia, 18 yrs. and older, hospitalized at two Mayo Clinic Rochester hospitals between January 1st 2005 and December 31st 2007, excluding ventilatory associated pneumonia. ALI was diagnosed based on the criteria by the North American/European consensus conference definition.
Among 543 patients, 338 (62,3%) men, median age 65 yrs. (interquartile range [IQR], 53–76), 151 (27.8%) were diagnosed with ALI. ALI less commonly complicated community-acquired (n=57, 21.2%) than healthcare-associated (n=42, 30.7%, p=0.04) and hospital-acquired pneumonia (n=52, 38.0%, p<0.001). The occurrence of ALI was less frequent in bacterial (n=101, 24.5%) than in viral (n=19, 34.6%), fungal (n=19, 41.3%) and mixed isolates (n=12, 41.4%) (p=0.02). Figure 1 presents the frequency of ALI according to the most common specific pathogens. Hospital mortality was higher among ALI patients (36.4% vs 8.4%, p<0.001).
ALI commonly complicates infectious pneumonia in hospitalized patients. The occurrence of ALI varies among pathogen groups and is associated with increased mortality.
Clinicians should be aware of ALI risk in patients hospitalized with infectious pneumonia. Better understanding of the mechanisms of observed associations are required prior to design of effective preventive strategies.
Marija Kojicic, No Financial Disclosure Information; No Product/Research Disclosure Information