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Table 1 Demographics, severity of disease, clinical, laboratory, radiological findings on admission, microbiology and empiric antibiotic therapy of the study population, according to the three study groups

From: Phenotyping community-acquired pneumonia according to the presence of acute respiratory failure and severe sepsis

Characteristic Group A Group B Group C p (Among 3 groups) p (Group B vs. Group C)
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
  1. n: number; IQR: 25–75 interquartile range; COPD: chronic obstructive pulmonary disease; CAP: community-acquired pneumonia; PSI: pneumonia severity index; ICU: intensive care unit; CXR: chest radiograph; ESBL: extended-spectrum beta-lactamase; MDR: multidrug resistant (including methicillin-resistant S. aureus, Pseudomonas aeruginosa resistant to antipseudomonal penicillins, cephalosporins, carbapenems, and quinolones, Stenotrophomonas maltophilia, vancomycin-resistant Enterococcus, Acinetobacter baumanii, extended spectrum b-lactamase producing Enterobacteriaceae, and other non-fermenting Gram-negative bacilli); SpO2: oxygen saturation; PaO2: partial pressure of oxygen in arterial blood; PaCO2: partial pressure of carbon dioxide in arterial blood. +Hypotension defined as Systolic blood pressure <90 mm Hg or diastolic blood pressure < 60 mm Hg. Differences in continuous variables were monitored with Kruskal-Wallis test (three groups) and Mann–Whitney U Test differences (two groups); differences in proportions were monitored with ANOVA (three groups) and the chi square test (two groups).
  2. Group A: Community-acquired pneumonia (CAP) patients with neither acute respiratory failure (ARF) nor severe sepsis (SS) on admission. Group B: CAP patients with only ARF on admission. Group C: CAP patients with both ARF and SS on admission.