Regueiro-Mira María Virtudes, Pita-Fernández Salvador, Pértega-Díaz Sonia, López-Calviño Beatriz, Seoane-Pillado Teresa, Fernández-Albalat-Ruiz María
Rev Chilena Infectol. 2015 Aug;32(4):435-44. doi: 10.4067/S0716-10182015000500010.
Legionellosis is a multisystem bacterial disease, which causes pneumonia with high mortality in patients with comorbidity and admitted in intensive care units (ICU).
Determine predictors of mortality or ICU admission.
Retrospective follow-up of patients diagnosed with Legionella pneumophila pneumonia in Complexo Hospitalario Universitario de A Coruña. Period 2000-2013 (n=240). Analysis of multivariate logistic regression was performed.
Mean age was 57.2±15.4 years old, 88.3% were male. Average score of comorbidity (Charlson score) was 2.3±2.3. There was a clear seasonal variation. Predominant symptoms were fever (92.5%), dry cough (38.1%) and dyspnea (33.9%). Creatinine clearance was lower than 60 mL/min/1.73 m² in 29.7% and sodium<135 mEq/l in 58.3%. Admission to ICU rate was 16.3% and 10.8% needs mechanical ventilation. Inhospital mortality rate was 4.6%, rising to 23.1% in patients admitted to ICU. Variables associated to predict ICU admission were age (OR=0.96), liver disease (OR=7.13), dyspnea (OR=4.33), delirium (OR=5.86) and high levels of lactatedehydrogenase (OR=1.002). Variables associated with inhospital mortality were Charlson index (OR=1.70), mechanical ventilation (OR=31.44) and high levels of lactatedehydrogenase (OR=1.002).
Younger patients with liver disease, dyspnea and confusion are more likely to be admitted to ICU. Comorbidity, mechanical ventilation and elevated LDH levels are associated with higher mortality rate.
军团病是一种多系统细菌性疾病，在合并症患者中可导致肺炎，且入住重症监护病房（ICU）的患者死亡率很高。
确定死亡率或入住ICU的预测因素。
对在拉科鲁尼亚大学综合医院诊断为嗜肺军团菌肺炎的患者进行回顾性随访。时间段为2000 - 2013年（n = 240）。进行多因素逻辑回归分析。
平均年龄为57.2±15.4岁，88.3%为男性。合并症平均评分（查尔森评分）为2.3±2.3。存在明显的季节性变化。主要症状为发热（92.5%）、干咳（38.1%）和呼吸困难（33.9%）。29.7%的患者肌酐清除率低于60 mL/min/1.73 m²，58.3%的患者血钠<135 mEq/l。入住ICU率为16.3%，10.8%的患者需要机械通气。住院死亡率为4.6%，入住ICU的患者死亡率升至23.1%。与预测入住ICU相关的变量有年龄（OR = 0.96）、肝病（OR = 7.13）、呼吸困难（OR = 4.33）、谵妄（OR = 5.86）和高乳酸脱氢酶水平（OR = 1.002）。与住院死亡率相关的变量有查尔森指数（OR = 1.70）、机械通气（OR = 31.44）和高乳酸脱氢酶水平（OR = 1.002）。
患有肝病、呼吸困难且出现意识障碍的年轻患者更有可能入住ICU。合并症、机械通气和升高的乳酸脱氢酶水平与较高的死亡率相关。
