Clinical characteristics and prognosis of pneumonia and sepsis: multicenter study

Background. Pneumonia is the primary source of sepsis and is significantly associated with mortality. However, only a few studies focus on its clinical characteristics and outcomes. Methods. We evaluated 500 intensive care unit patients who met severe sepsis or septic shock criteria, dividing them into two distinct groups (43%, sepsis with pneumonia; 41%, sepsis with an infection other than pneumonia). Results. Moderate differences between the groups were observed. The group of sepsis with pneumonia had a higher 28-day in-hospital mortality (41% vs. 30%; P=0.02). Multivariate analysis revealed that the presence of pneumonia associated significantly with mortality (OR 1.76, 95% CI 1.11-2.78) along with cardiopulmonary resuscitation (OR 4.20, 95% CI 1.50-11.74), serum lactate >= 3.5 mmol/L (OR 1.92, 95% CI 1.20-3.08), and SOFA score >= 12 (OR 2.41, 95% CI 1.52-3.82). Survival analysis revealed for both groups that the patients with PaO2/FiO(2) (PF) ratio <170 and lactate >= 3.5 mmol/L had a worse prognosis than the patients with PF ratio >= 170 and lactate >= 3.5 mmol/L or PP ratio <170 and lactate <3.5 mmol/L. Conclusion. In patients admitted with sepsis, the pneumonia infection independently predicts 28-day in-hospital mortality. Combining the levels of serum lactate and PF ratio could be a useful approach in predicting mortality of these patients.