期刊
EUROPEAN RESPIRATORY JOURNAL
卷 38, 期 5, 页码 1173-1179出版社
EUROPEAN RESPIRATORY SOC JOURNALS LTD
DOI: 10.1183/09031936.00000211
关键词
Community-acquired pneumonia; empyema; pleural effusion
资金
- Ciber de Enfermedades Respiratorias from the Instituto de Salud Carlos III, Madrid, Spain [CIBERES CB06/06/0028]
- European Development Regional Fund [REIPI RD06/'''8]
We aimed to determine the incidence, clinical consequences and microbiological findings related to the presence of pleural effusion in community-acquired pneumonia, and to identify predictive factors for empyema/complicated parapneumonic effusion. We analysed 4,715 consecutive patients with community-acquired pneumonia from two acute care hospitals. Patients were classified into three groups: no pleural effusion, uncomplicated parapneumonic effusion and empyema/complicated parapneumonic effusion. A total of 882 (19%) patients had radiological evidence of pleural fluid, of whom 261 (30%) met criteria for empyema/complicated parapneumonic effusion. The most important event related to the presence of uncomplicated parapneumonic effusion was a longer hospital stay. Relevant clinical and microbiological consequences were associated with empyema/complicated parapneumonic effusion. Five independent baseline characteristics could predict the development of empyema/complicated parapneumonic effusion: age <60 yrs (p=0.012), alcoholism (p=0.002), pleuritic pain (p=0.002), tachycardia >100 beats.min(-1) (p=0.006) and leukocytosis >15,000 mm(-3) (p<0.001). A higher incidence of anaerobes and Gram-positive cocci was found in this subgroup of patients. We conclude that only the development of empyema/complicated parapneumonic effusion carried relevant consequences; this condition should be suspected in the presence of some baseline characteristics and managed by using antimicrobials active against Gram-positive cocci and anaerobes.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据