Acute community-acquired XXXX in adults admitted to the intensive care unit: clinical manifestations, management and prognostic factors.

@entity1 @entity2656 @entity1032 @entity410 @entity4008 @entity772 @entity51 @entity619 @entity204
OBJECTIVE: To study the clinical features, management and prognostic factors associated with adverse clinical outcome in a series of @entity1 with acute community-acquired @entity4008 admitted to the intensive care unit (ICU). DESIGN AND SETTING: Descriptive, prospective study at two ICUs of a university hospital over a 6-year period. @entity1 : Sixty-four episodes in 62 adults with acute community-acquired @entity4008 admitted to the ICU. RESULTS: Most of the @entity1 (95.3%) were admitted to the ICU presenting with @entity1032 (the median value of Glasgow @entity772 Scale (GCS) was 11). Overall mortality rate was 10.9% (7 @entity1 ) and 11 (17.1%) developed adverse clinical outcome ( @entity204 or severe @entity51 ). The features associated with adverse clinical outcome were: age over 50 years, @entity410 or focal neurologic signs at admission, a GCS score of 10 or less and an APACHE II score more than 13 at admission to the ICU. Only the severity of the disease determined according to the APACHE II scale was independently associated with adverse clinical outcome after a multivariate analysis was performed (adjusted odds ratio =8.74; 95% CI =1.70-44.77; p=0.009). All @entity1 were empirically treated with third-generation cephalosporins and @entity619 was used in 40 cases (62.5%). Ten @entity1 (15.6%) received @entity2656 , nine of them after a transcranial Doppler sonography recording had been performed. CONCLUSIONS: In adult @entity1 with acute community-acquired @entity4008 admitted to the ICU, the overall severity of the disease within 24 h of admission may be the major indicator of adverse in-hospital clinical outcome.
