n. (%)
|
954 (100)
|
771 (100)
|
420 (100)
| | |
Demographics
| | | | | |
Male, n. (%)
|
451 (47)
|
368 (48)
|
186 (44)
|
0.492
|
0.255
|
Age, median (IQR) years
|
67 (47–81)
|
75 (61–83)
|
75 (61–84)
|
<0.001
|
0.868
|
Comorbidities, n. (%)
| | | | | |
Congestive heart failure
|
148 (16)
|
170 (22)
|
103 (25)
|
<0.001
|
0.332
|
Chronic obstructive pulmonary disease
|
139 (15)
|
237 (31)
|
115 (27)
|
<0.001
|
0.225
|
Diabetes mellitus
|
111 (12)
|
118 (15)
|
61 (15)
|
0.069
|
0.731
|
Cerebrovascular disease
|
83 (9)
|
93 (12)
|
70 (17)
|
<0.001
|
0.027
|
Chronic renal failure
|
63 (7)
|
63 (8)
|
68 (16)
|
<0.001
|
<0.001
|
Liver disease
|
52 (6)
|
27 (4)
|
32 (8)
|
0.008
|
0.002
|
Residency in a nursing home
|
46 (5)
|
63 (8)
|
54 (13)
|
<0.001
|
0.009
|
Severity on admission, n. (%)
| | | | | |
PSI Risk Class IV and V
|
332 (35)
|
464 (60)
|
343 (82)
|
<0.001
|
<0.001
|
CURB-65 score 3, 4 and 5
|
127 (13)
|
198 (26)
|
231 (55)
|
<0.001
|
<0.001
|
Admission to ICU
|
6 (0.6)
|
54 (7)
|
90 (21)
|
<0.001
|
<0.001
|
Physical findings on admission, median (IQR)
| | | | | |
Systolic blood pressure, mmHg
|
127 (112–145)
|
130 (115–150)
|
108 (85–133)
|
<0.001
|
<0.001
|
Diastolic blood pressure, mmHg
|
70 (64–80)
|
71 (62–80)
|
60 (50–72)
|
<0.001
|
<0.001
|
Heart rate, beats/minute
|
95 (83–107)
|
100 (85–114)
|
110 (100–120)
|
<0.001
|
<0.001
|
Respiratory rate, breaths/minute
|
20 (18–26)
|
24 (20–30)
|
30 (24–34)
|
<0.001
|
<0.001
|
SpO2,%
|
96 (95–97)
|
92 (89–95)
|
90 (85–93)
|
<0.001
|
<0.001
|
Laboratory values, median (IQR)
| | | | | |
Arterial pH
|
7.45 (7.42-7.48)
|
7.44 (7.40-7.48)
|
7.39 (7.31-7.46)
|
<0.001
|
<0.001
|
PaO2/FiO2 ratio
|
339 (318–378)
|
256 (216–279)
|
229 (182–276)
|
<0.001
|
<0.001
|
PaCO2, mmHg
|
33 (29–38)
|
36 (31–42)
|
36 (30–48)
|
<0.001
|
0.164
|
Respiratory acidosis, n. (%)
|
0 (0)
|
59 (8)
|
47 (13)
|
<0.001
|
0.014
|
White blood cells, cell/L−1
|
11900 (8238–16300)
|
12790 (9100–17000)
|
144000 (9993–19000)
|
<0.001
|
0.001
|
Platelet, cell/L−1
|
232000 (182000–300500)
|
237000 (186500–317000)
|
233000 (166750–307250)
|
0.054
|
0.028
|
Hemoglobin, g/dL
|
13 (12–14)
|
13 (12–14)
|
13 (11–14)
|
0.010
|
0.021
|
Hematocrit,%
|
39 (36–42)
|
40 (37–44)
|
39 (34–43)
|
<0.001
|
0.001
|
Urea, mg/dL
|
37 (27–54)
|
45 (31–64)
|
63 (42–103)
|
<0.001
|
<0.001
|
Creatinine, mg/dL
|
0.9 (0.8-1.2)
|
1.0 (0.8-1.2)
|
1.2 (0.9-1.9)
|
<0.001
|
<0.001
|
Sodium, mEq/L
|
137 (134–139)
|
137 (134–139)
|
136 (133–140)
|
0.650
|
0.409
|
Glucose, mg/dL
|
105 (73–128)
|
113 (74–148)
|
101 (65–149)
|
0.002
|
0.035
|
Radiology findings on CXR, n. (%)
| | | | | |
Multilobar involvement
|
161 (18)
|
195 (28)
|
141 (36)
|
<0.001
|
0.003
|
Pleural effusion
|
204 (22)
|
150 (20)
|
100 (24)
|
0.209
|
0.078
|
Microbiological findings, n. (%)
| | | | | |
Patients with isolated bacteria
|
184 (19)
|
198 (26)
|
141 (34)
|
<0.001
|
0.004
|
Polymicrobial infection
|
3 (2)
|
8 (4)
|
4 (3)
|
0.369
|
0.547
|
Patients with > = one MDR pathogen
|
17 (4)
|
20 (5)
|
22 (8)
|
0.015
|
0.060
|
S. pneumoniae
|
90 (49)
|
114 (58)
|
64 (45)
|
0.064
|
0.027
|
S. aureus
|
15 (8)
|
19 (10)
|
23 (16)
|
0.049
|
0.064
|
Legionella pneumophila
|
16 (9)
|
16 (8)
|
5 (4)
|
0.156
|
0.088
|
Respiratory viruses
|
11 (6)
|
12 (6)
|
13 (9)
|
0.439
|
0.273
|
Atypicals
|
31 (17)
|
22 (11)
|
9 (6)
|
0.014
|
0.137
|
H. influenzae
|
17 (9)
|
14 (7)
|
7 (5)
|
0.328
|
0.419
|
Empiric antibiotic therapy, n. (%)
| | | | | |
Levofloxacin
|
287 (30)
|
234 (30)
|
106 (25)
|
0.133
| |
Ceftriaxone
|
348 (37)
|
324 (42)
|
145 (35)
|
0.015
| |
Amoxicillin (clavulanate)
|
295 (31)
|
218 (28)
|
148 (35)
|
0.045
| |
Azithromycin
|
230 (24)
|
189 (25)
|
72 (17)
|
0.007
| |
Clarithromycin
|
198 (21)
|
211 (27)
|
152 (36)
|
<0.001
| |
Piperacillin/tazobactam
|
34 (3.6)
|
44 (5.7)
|
43 (10)
|
<0.001
| |
Antibiotics compliant with local guidelines
|
731 (81)
|
595 (79)
|
328 (79)
|
0.606
|
0.933
|
Outcomes
| | | | | |
Length of hospital stay, median (IQR) days
|
6 (3–11)
|
9 (6–14)
|
12 (7–21)
|
<0.001
|
0.004
|
In-hospital mortality, n. (%)
|
43 (4.2)
|
72 (9.3)
|
108 (26)
|
<0.001
|
<0.001
|