Factors of Menendez et al Affecting Time to Clinical Stability and Complications in a Patient Hospitalized for Community-Acquired Pneumonia

 

Parameters for clinical stability were measured at admission or during the first 24 hours after admission. Parameters for outcome included initial findings as well as those that developed during the course of hospitalization.

 

Factors Associated with a Delayed Time to Clinical Stability	Factors Associated with Complications and Delayed Response to Therapy
dyspnea	dyspnea
confusion	confusion
pleural effusion	empyema
multilobed pneumonia	multilobed pneumonia
maximum pneumonia severity index III, IV or V	initial pneumonia severity index III, IV or V
compliance with clinical guidelines for treatment of CAP
	chronic bronchitis
	treatment failure
	cardiac complications
	respiratory complications
	admission to the ICU

 

where:

• Pneumonia severity was measured using the Pittsburgh Pneumonia Prognostic Index of Fine et al (above, 23.04.02).

• Respiratory complications included new respiratory failure, exacerbation of concomitant respiratory disease, or pleural effusion (page 1784; I would think empyema could also be included here).

• Using the presence of cardiac and respiratory complications as risk factors for complications seems a bit circuitous.

 

Interpretation:

• maximum number of factors delaying clinical stability: 6

• maximum number of factors associated with complications or delayed response: 10