Montull, BeatrizMenéndez, RosarioTorres, AntoniReyes, SoledadMéndez, RaúlZalacaín, RafaelCapelastegui, AlbertoRajas, OlgaBorderías, LuisMartin-Villasclaras, JuanBello, SalvadorAlfageme, InmaculadaRodríguez de Castro, FelipeRello, JordiMolinos, LuisRuiz-Manzano, Juan2016-09-062016-09-062016-01-04Montull B, Menéndez R, Torres A, Reyes S, Méndez R, Zalacaín R, et al. Predictors of Severe Sepsis among Patients Hospitalized for Community-Acquired Pneumonia. PLoS ONE. 2016; 11(1):e0145929http://hdl.handle.net/10668/2394Journal Article; Multicenter Study; Observational Study;BACKGROUND Severe sepsis, may be present on hospital arrival in approximately one-third of patients with community-acquired pneumonia (CAP). OBJECTIVE To determine the host characteristics and micro-organisms associated with severe sepsis in patients hospitalized with CAP. RESULTS We performed a prospective multicenter cohort study in 13 Spanish hospital, on 4070 hospitalized CAP patients, 1529 of whom (37.6%) presented with severe sepsis. Severe sepsis CAP was independently associated with older age (>65 years), alcohol abuse (OR, 1.31; 95% CI, 1.07-1.61), chronic obstructive pulmonary disease (COPD) (OR, 1.75; 95% CI, 1.50-2.04) and renal disease (OR, 1.57; 95% CI, 1.21-2.03), whereas prior antibiotic treatment was a protective factor (OR, 0.62; 95% CI, 0.52-0.73). Bacteremia (OR, 1.37; 95% CI, 1.05-1.79), S pneumoniae (OR, 1.59; 95% CI, 1.31-1.95) and mixed microbial etiology (OR, 1.65; 95% CI, 1.10-2.49) were associated with severe sepsis CAP. CONCLUSIONS CAP patients with COPD, renal disease and alcohol abuse, as well as those with CAP due to S pneumonia or mixed micro-organisms are more likely to present to the hospital with severe sepsis.enInfecciones adquiridas en la comunidadAncianoFemeninoHumanosDuración de estancia hospitalariaMasculinoMediana edadNeumonía bacterianaNeumonía víricaEstudios prospectivosFactores de riesgoSepsisÍndice de la gravedad de la enfermedadMedical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Community-Acquired InfectionsMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Services::Patient Care::Hospitalization::Length of StayMedical Subject Headings::Check Tags::MaleMedical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle AgedMedical Subject Headings::Diseases::Respiratory Tract Diseases::Lung Diseases::Pneumonia::Pneumonia, BacterialMedical Subject Headings::Diseases::Respiratory Tract Diseases::Lung Diseases::Pneumonia::Pneumonia, ViralMedical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Prospective StudiesMedical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Statistics as Topic::Probability::Risk::Risk FactorsMedical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::SepsisMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Health Surveys::Health Status Indicators::Severity of Illness IndexMedical Subject Headings::Named Groups::Persons::Age Groups::Adult::Agedresearch article26727202open access10.1371/journal.pone.01459291932-6203PMC4699794