Prognosis and outcomes of patients with community-acquired pneumonia: a meta-analysis

Article Abstract:

Researchers used meta-analysis to evaluate 127 studies on community-acquired pneumonia (CAP) covering 33,148 patients that were published from 1966 to 1995. The overall mortality rate was 13.7%, but rates in individual studies ranged from 5.1% in hospitalized and ambulatory patients to 36.5% in an intensive care unit. Eleven factors were found to predict mortality and included male sex, chest pain, hypothermia, hypotension and pulmonary infiltrate. Most of these factors are known at the time of admission and could be used to predict mortality. Mortality was also associated with the type of bacterium involved, being highest in patients infected with Pseudomonas, Klebsiella, E. coli and Staphylococcus aureus. Only one-third of the studies reported any other complications of CAP and less than 10% reported on functional outcomes such as return to work or regular activities.

Prognosis

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Medical outcomes and antimicrobial costs with the use of the American Thoracic Society guidelines for outpatients with community-acquired pneumonia

Article Abstract:

The guidelines for treating community-acquired pneumonia (CAP) recommended by the American Thoracic Society appear to be acceptable for patients under the age of 60 but not acceptable for those over 60 or those with co-existing diseases. Researchers compared drug costs and medical outcomes in 864 patients with CAP treated at hospitals that did or did not follow the guidelines. The guidelines reduced drug costs about one-third in the young patients without compromising their outcome. However, drug costs were 10 times higher in the elderly group treated under the guidelines with no improvement in outcome.

Evaluation, Drug therapy, Science and technology policy, Practice guidelines (Medicine), American Thoracic Society

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A prediction rule to identify low-risk patients with community-acquired pneumonia

Article Abstract:

Some patients with community-acquired pneumonia may be predicted to have a lower risk of death and could be treated on an outpatient basis. Researchers analyzed the records of 14,199 adult hospital inpatients with community-acquired pneumonia to develop a prediction rule for the risk of death within one month. Patients who are under 50 and have no history of cancer, heart failure, stroke, kidney or liver disease, and who have stable vital signs and mental status have the lowest risk of death. The prediction rule includes a total of five risk groups.

Care and treatment

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