PMID- 27405854
OWN - NLM
STAT- MEDLINE
DCOM- 20180109
LR  - 20181113
IS  - 1432-1750 (Electronic)
IS  - 0341-2040 (Linking)
VI  - 194
IP  - 5
DP  - 2016 Oct
TI  - The Roles of the Charlson Comorbidity Index and Time to First Antibiotic Dose as 
      Predictors of Outcome in Pneumococcal Community-Acquired Pneumonia.
PG  - 769-75
LID - 10.1007/s00408-016-9922-z [doi]
AB  - PURPOSE: In this retrospective study, we aimed to investigate the role of 
      comorbidities using the Charlson comorbidity index (CCI) and time to first 
      antibiotic dose (TFAD) in patients with pneumococcal community-acquired pneumonia 
      (PCAP). METHODS: All consecutive ER admissions with PCAP who were hospitalized in 
      the University Hospital, Zurich between 2006 and 2012 were included. The primary 
      outcome was to determine possible determinants of all-cause in-hospital mortality 
      (ACIHM). The second endpoint was to detect risk factors for adverse events (AEs) 
      and determinants of length of stay (LOS). RESULTS: 108 subjects (mean age 
      57.6 years) were included. The median (IQR) CCI was 4 (1, 8). The median (IQR) 
      TFAD was 210 (150, 280) min. ACIHM was 6.5 % (7/108), and median (IQR) LOS was 9 
      (6, 14) days. PCAP-related AEs were observed in 57 cases (52.8 %). In the 
      multivariable analysis, neither CCI nor TFAD was associated with the outcome 
      measures. Pneumonia severity index (PSI) was the only statistically significant 
      predictor of ACIHM (HR 1.31/10 point increase, 95 % CI 1.12-1.53, p = 0.001) and 
      AE rate (OR 1.31, 95 % CI 1.15-1.50, p < 0.001). CONCLUSIONS: In this study 
      including comparatively young patients with rather mild disease severity, we 
      found no strong evidence supporting that CCI or TFAD influenced short-term 
      outcome measures of PCAP. Yet, pneumonia severity appears to be the most 
      important factor for the outcome.
FAU - Franzen, Daniel
AU  - Franzen D
AUID- ORCID: 0000-0001-6080-9555
AD  - Department of Pulmonology, University Hospital and University of Zurich, 
      Raemistrasse 100, 8091, Zurich, Switzerland. daniel.franzen@usz.ch.
FAU - Lim, Marisa
AU  - Lim M
AD  - Department of Pulmonology, University Hospital and University of Zurich, 
      Raemistrasse 100, 8091, Zurich, Switzerland.
FAU - Bratton, Daniel J
AU  - Bratton DJ
AD  - Department of Pulmonology, University Hospital and University of Zurich, 
      Raemistrasse 100, 8091, Zurich, Switzerland.
FAU - Kuster, Stefan P
AU  - Kuster SP
AD  - Department of Infectious Diseases and Hospital Epidemiology, University Hospital 
      and University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
FAU - Kohler, Malcolm
AU  - Kohler M
AD  - Department of Pulmonology, University Hospital and University of Zurich, 
      Raemistrasse 100, 8091, Zurich, Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20160712
PL  - United States
TA  - Lung
JT  - Lung
JID - 7701875
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-Bacterial Agents/administration & dosage
MH  - Community-Acquired Infections/complications/drug therapy/*mortality
MH  - *Comorbidity
MH  - Drug Therapy, Combination
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Pneumonia, Pneumococcal/complications/drug therapy/*mortality
MH  - Risk Factors
MH  - *Severity of Illness Index
MH  - Switzerland/epidemiology
MH  - *Time-to-Treatment
OTO - NOTNLM
OT  - Comorbidity
OT  - Pneumococcal community-acquired pneumonia
OT  - Pneumonia severity index
OT  - Short-term outcome
OT  - Time to first antibiotic dose
EDAT- 2016/07/14 06:00
MHDA- 2018/01/10 06:00
CRDT- 2016/07/14 06:00
PHST- 2016/04/06 00:00 [received]
PHST- 2016/07/03 00:00 [accepted]
PHST- 2016/07/14 06:00 [entrez]
PHST- 2016/07/14 06:00 [pubmed]
PHST- 2018/01/10 06:00 [medline]
AID - 10.1007/s00408-016-9922-z [pii]
AID - 10.1007/s00408-016-9922-z [doi]
PST - ppublish
SO  - Lung. 2016 Oct;194(5):769-75. doi: 10.1007/s00408-016-9922-z. Epub 2016 Jul 12.