Is it possible to predict which patients with mild pneumonias will develop hypoxemia?

Francisco Sanz, Marcos I. Restrepo, Estrella Fernández, Maria Luisa Briones, Rafael Blanquer, Eric M. Mortensen, Eusebi Chiner, Jose Blanquer

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Usually, mortality due to mild community-acquired pneumonias (CAP) (Pneumonia severity index (PSI) classes I-III) is low (<3%), but the appearance of hypoxemia significantly increases mortality. Our aim was to determine the clinical parameters associated with risk factors of developing hypoxemia in subjects with mild CAP (PSI I-III) and the clinical outcomes of the hypoxemic group. We analyzed clinical characteristics and the outcomes of patients with mild CAP and hypoxemia (PaO2/FiO2 < 300), in a prospective, multicenter cohort study of 1195 patients. Mild pneumonias (PSI I-III) were found in 645 cases (53.9%), of which 217 (33.6%) presented hypoxemia according to a PaO2/FiO2 < 300. Patients with PaO2/FiO2 < 300 required more ICU admissions, mechanical ventilation, and developed septic shock than other PSI I-III patients. The clinical parameters associated with hypoxemia were: COPD, bilateral chest X-ray involvement, and hypoalbuminemia. We conclude that patients with COPD, those with bilateral chest X-ray involvement, or hypoalbuminemia were significantly more likely to have hypoxemia in mild CAP. Hypoxemic patients with low-risk pneumonia have worse clinical outcomes, including more ICU admission, need for mechanical ventilation and presence of septic shock than non-hypoxemic low-risk patients.

Original languageEnglish (US)
Pages (from-to)1871-1877
Number of pages7
JournalRespiratory Medicine
Volume103
Issue number12
DOIs
StatePublished - Dec 2009

Fingerprint

Pneumonia
Hypoalbuminemia
Septic Shock
Artificial Respiration
Chronic Obstructive Pulmonary Disease
Thorax
X-Rays
Hypoxia
Mortality
Multicenter Studies
Cohort Studies

Keywords

  • Community-acquired pneumonia
  • Hypoxemia
  • Risk factors
  • Severity assessment

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Sanz, F., Restrepo, M. I., Fernández, E., Briones, M. L., Blanquer, R., Mortensen, E. M., ... Blanquer, J. (2009). Is it possible to predict which patients with mild pneumonias will develop hypoxemia? Respiratory Medicine, 103(12), 1871-1877. https://doi.org/10.1016/j.rmed.2009.06.013

Is it possible to predict which patients with mild pneumonias will develop hypoxemia? / Sanz, Francisco; Restrepo, Marcos I.; Fernández, Estrella; Briones, Maria Luisa; Blanquer, Rafael; Mortensen, Eric M.; Chiner, Eusebi; Blanquer, Jose.

In: Respiratory Medicine, Vol. 103, No. 12, 12.2009, p. 1871-1877.

Research output: Contribution to journalArticle

Sanz, F, Restrepo, MI, Fernández, E, Briones, ML, Blanquer, R, Mortensen, EM, Chiner, E & Blanquer, J 2009, 'Is it possible to predict which patients with mild pneumonias will develop hypoxemia?', Respiratory Medicine, vol. 103, no. 12, pp. 1871-1877. https://doi.org/10.1016/j.rmed.2009.06.013
Sanz, Francisco ; Restrepo, Marcos I. ; Fernández, Estrella ; Briones, Maria Luisa ; Blanquer, Rafael ; Mortensen, Eric M. ; Chiner, Eusebi ; Blanquer, Jose. / Is it possible to predict which patients with mild pneumonias will develop hypoxemia?. In: Respiratory Medicine. 2009 ; Vol. 103, No. 12. pp. 1871-1877.
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