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Vol. 14. Issue 5.
Pages 601-615 (September - October 2008)
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Vol. 14. Issue 5.
Pages 601-615 (September - October 2008)
Artigo Original/Original Article
Open Access
Internamento devido a PAC por Streptococcus pneumoniae – Avaliação de factores de mortalidade
Streptococcus pneumoniae – caused CAP in hospitalised patients: mortality predictors
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Sandra Figueiredo1, Ana Paula Vaz1, João Bento1, Maria Dolores Pinheiro3, Adelina Amorim2, Carla Damas2
1 Internato Médico. Serviço de Pneumologia do Hospital de São João (EPE), Porto / Resident, Pulmonology Unit, Hospital de São João (EPE)
2 Assistente Hospitalar. Serviço de Pneumologia do Hospital de São João (EPE), Porto / Consultant, Pulmonology Unit, Hospital de São João (EPE)
3 Assistente Hospitalar Graduada do Laboratório de Microbiologia. Serviço de Patologia Clínica do Hospital de São João (EPE), Porto / Consultant, Microbiology Laboratory specialist, Clinical Pathology Unit, Hospital de São João (EPE)
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Resumo

A avaliação da gravidade perante qualquer caso de pneumonia adquirida na comunidade (PAC) é de suma importância, pois dela decorrem decisões como a necessidade de internamento e o tratamento empírico inicial. Os autores apresentam um estudo retrospectivo, que incluiu doentes internados devido a pneumonia por Streptococcus pneumoniae durante o ano de 2006, no Hospital de São João. A confirmação etiológica de infecção foi feita por isolamentos no sangue, líquido pleural, secreções traqueobrônquicas, lavado brônquico, lavado broncoalveolar e pesquisa de antigenúria. Foram analisados os factores de risco e avaliados, com base nas normas PSI (Pneumonia Severity Index) e da British Thoracic Society (BTS) -CURB-65. A análise estatística foi efectuada utilizando teste T para amostras independentes e ANOVA, usando o programa de análise estatística SPSS 14.0.

Foram incluídos 104 doentes com idade mediana de 63 anos, sendo 67,3% do sexo masculino. O estudo revelou existir uma associação com significado estatístico entre os resultados de PSI e CURB-65 e a evolução para a mortalidade.

Apesar da melhoria dos meios diagnósticos e profilácticos, e da terapêutica antibiótica, a pneumonia pneumocócica permanece uma entidade de grande morbilidade e mortalidade. O valor preditivo das normas PSI e CURB-65 foi confirmado nesta população de doentes, documentando uma correlação entre o número de factores de risco e a evolução da doença.

Rev Port Pneumol 2008; XIV (5): 601-615

Palavras-chave:
Pneumonia adquirida na comunidade
Streptococcus pneumoniae
Abstract

Probably the most important decision in the management of Community-Acquired Pneumonia (CAP) is patient site of care. Patients with Streptococcus pneumoniae-caused CAP admitted to our hospital between 1st January and 31st December 2006 were retrospectively analysed. Samples of blood, sputum, bronchial and bronchoalveolar lavage and urine were collected for microbiological testing using standard culture techniques and urine antigen detection. Pneumonia Severity Index (PSI) and British Thoracic Society (BTS) CURB-65 scoring tools were evaluated. The statistical treatment was performed using the SPSS 14.0 program. We included 104 patients, 67.3% male, median age 63 years old, mortality 13.4%. There was a significant association between the PSI and CURB-65 score and mortality. Despite advances, CAP is still an important health problem with a high attendant morbi-mortality. This study confirms the value of PSI and CURB-65 in the prediction of severe pneumonia.

Rev Port Pneumol 2008; XIV (5): 601-615

Key-words:
Community-acquired pneumonia
Streptococcus pneumoniae
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Copyright © 2008. Sociedade Portuguesa de Pneumologia/SPP
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