| Popis: |
Aim. To evaluate the influence of the initial pneumonia treatment effectiveness, clinical and etiological factors, local innate immune response intensity on pneumonia non-resolution and mortality. Materials and methods. One hundred one bronchoscopy and bronchoalveolar lavage performed to 68 severe community (CAP) or hospital-acquired pneumonia patients survived during initial 5–7-day treatment period. Initial treatment effectiveness, age, pneumonia type, presence of mechanical ventilation, comorbidities, coma, antibacterial treatment, pathogen isolation and treatment changes were assessed. Logistic regression analysis was performed to detect factors associated with non-resolving pneumonia and mortality. Results: Etiotropical treatment was administered to 30.9% of patients. Initial antibacterial treatment was corrected in 64.7% of all cases. After 21–30 days from the pneumonia onset survived 66.2% of patients (n=43). Pneumonia course could be evaluated in 52 cases. Delayed resolution of the pneumonia was stated in 32.7% of cases (n=17). Pneumonia was cured or condition improved in 64.3% of the CAP patients (n=9) and 68.4% of the hospital-acquired pneumonia patients (n=26). Only ineffective initial pneumonia treatment significantly increased probability of non-resolving pneumonia on multivariate analysis (OR 16.92, 95% CI 2.02–141.72, p |
