SAN FRANCISCO — Patients with community-acquired pneumonia who were admitted to the intensive care unit 2 or more days after diagnosis were more than twice as likely to die within 30 days as were those who were admitted in 24 hours or less, according to a poster presentation at the International Conference of the American Thoracic Society.
The retrospective, observational study involved 161 patients seen over a 3-year period at two tertiary care hospitals in San Antonio. All patients were 18 years old or older, all had received a chest x-ray within 24 hours of admission, and all had a diagnosis consistent with community-acquired pneumonia, wrote Dr. Marcos I. Restrepo and his colleagues at the University of Texas at San Antonio.
There were no significant differences in demographic or clinical characteristics between the 142 patients admitted to the ICU early and the 19 admitted late. There were also no significant differences between the two groups in whether they received antibiotics within 4 hours, whether their blood was cultured appropriately, or whether they received guideline-concordant antibiotic therapy.
After 30 days, 47% of the patients who had been admitted late had died, compared with 23% of the patients who had been admitted early, a significant difference.
The investigators wrote that further research is needed to isolate the factors underlying the association between late ICU admission and increased mortality.