Survival in patients with nosocomial pneumonia: Impact of the severity of illness and the etiologic agent

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To assess the impact of severity of illness at different times, using the Mortality Probability Models (MPM II), and the impact of etiologic agent on survival in patients with nosocomial pneumonia.


Retrospective, observational study.


Fourteen-bed medical-surgical intensive care unit (ICU) in a teaching hospital.


Sixty-two patients with nosocomial pneumonia who were receiving early appropriate antibiotic treatment.



Measurements and Main Results

Severity of illness at the time of admission to the ICU (M0), 24 hrs after admission (M24), and at the time of pneumonia diagnosis (M1) was determined using MPM II. Bacteriology was established by quantitative cultures from bronchoscopic samples. The outcome measure was the crude mortality rate.


Severity of illness when pneumonia is diagnosed is the most important predictor of survival, and this determination should be used for therapeutic and prognostic stratification. In addition, the presence of P. aeruginosa contributed to an excess of mortality that could not be measured by MPM II alone, suggesting the importance of the pathogen in prognosis. (Crit Care Med 1997; 25:1862-1867)

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