Critical Care |

Differential Characteristics of Patients With Mild Acute Respiratory Distress Syndrome Due to Community-Acquired Pneumonia Admitted to ICU FREE TO VIEW

Laura Novella, MD; Francisco Sanz, PhD; Estrella Fernández-Fabrellas, PhD; Ángela Cervera, MD; Maria Luisa Briones, PhD; María Carmen Aguar, PhD; Ruben Lera, MD; Eusebi Chiner, PhD; Javier Berraondo, MD; Susana Herrera, MD; Cristina Miralles, MD; Marí Climent, MD; Dolores Martinez, MD; Lucia Gil, MD; José Blanquer, PhD
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Consorci Hospital General Universitari de Valencia, Valencia, Spain

Chest. 2014;145(3_MeetingAbstracts):176A. doi:10.1378/chest.1775773
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SESSION TITLE: Critical Care Posters II

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: To determine the characteristics of patients with community-acquired pneumonia and mild acute respiratory distress syndrome (CAP-mild ARDS) who require ICU admission.

METHODS: Analysis of demographic characteristics, comorbidities, etiology and outcomes of patients with CAP-mild ARDS admitted to ICU comparing to those who did not. X2, t student and logistic regression were used to compare both groups.

RESULTS: In a series of 1314 CAP patients, 164 (12.5%) showed mild ARDS at admission, of whom 25% (41 cases) were admitted to ICU. CAP-mild ARDS patients admitted to the ICU were younger [57.5 (16) vs. 68.7 (15.4) years, p<0.01], and had a lower duration of symptoms [3.4 (1.9) vs. 6.5 (6) days, p<0.01] than no ICU patients. Pneumonia severity was higher in ICU group (PSI V: 39% vs. 17.1%; p=0.004). Multivariate analysis showed that age <65 years (OR 9.79, 95%CI 3.13-30.68), septic shock (OR 7.76, 95%CI 2.36-25.50), and pneumonia severity (PSI V) (OR 7.28, 95%CI 2.16-24.56) were associated with ICU admission in CAP-mild ARDS patients; these patients showed a longer length of stay (LOS) [27 (28.6) vs. 10.6 (6) days, p<0.01] and more complications compared to those that were treated in a general ward (100% vs. 4.9%, p<0.01). There were no differences between the rate of etiologic diagnosis (58.8% vs. 43.1%, p= 0.086). Mortality was higher in ICU CAP mild-ARDS group but not statistically significant (17.1% vs. 7.3%, p= 0.068).

CONCLUSIONS: 1-In our series, 25% of patients with CAP-mild ARDS required ICU admission. 2- Age <65 years, the presence of septic shock, and pneumonia severity were factors that determine ICU admission of CAP-mild ARDS patients in our series. 3-Patients with CAP-mild ARDS and ICU admission showed more complications and longer LOS without differences in mortality.

CLINICAL IMPLICATIONS: Mild-ARDS could be found in near 25% of patients with CAP, and patients <65 years, high pneumonia severity and septic shock have high likelyhood to be admited in ICU.

DISCLOSURE: The following authors have nothing to disclose: Laura Novella, Francisco Sanz, Estrella Fernández-Fabrellas, Ángela Cervera, Maria Luisa Briones, María Carmen Aguar, Ruben Lera, Eusebi Chiner, Javier Berraondo, Susana Herrera, Cristina Miralles, Marí Climent, Dolores Martinez, Lucia Gil, José Blanquer

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