Acute XXXX in adults: prediction of mortality and failure of treatment.

@entity1 @entity6 @entity1790 @entity2885 @entity204
BACKGROUND: To formulate a classification tool for early recognition of @entity1 admitted with acute @entity2885 (AP) who are at high risk for failure of treatment or for @entity204 . METHODS: A retrospective chart review of 225 @entity1 (102 @entity1 ) admitted with AP. We considered 13 potential risk factors in a multivariate analysis. RESULTS: Recent hospitalization, previous use of antibiotics, and immunosuppression were found to be independent correlates of the prevalence of resistant pathogens in both sexes. Additional predictors included @entity1790 in @entity1 and a history of recurrent AP in @entity1 . Prolonged hospitalization should be expected for a @entity1 with @entity6 and long-term catheterization who is older than 65 years or for a @entity1 of any age with the same characteristics, when the initial treatment was changed according to the results of urine culture. For mortality prediction, we derived an integer-based scoring system with 6 points for shock, 4 for bedridden status, 4 for age greater than 65 years, and 3 for previous antibiotic treatment for @entity1 and 6 points for shock, 4 for bedridden status, 4 for age greater than 65 years, and 3 for immunosuppression for @entity1 . Among @entity1 with at least 11 points, the risk for in-hospital @entity204 was 100% for @entity1 and 91% for @entity1 . CONCLUSIONS: Simple variables available at presentation can be used for risk stratification of @entity1 with AP. The additional identification of certain risk factors by means of a carefully obtained history could contribute to early recognition of @entity1 infected by resistant bacteria and optimize the selection of antimicrobial agents.
