PaO2/FiO2 ≤ 250 mm Hg, confusion and uremia predicted more mortalities of severe community-acquired pneumonia with three IDSA/ATS minor criteria

Background The Infectious Disease Society of America (IDSA)/American Thoracic Society (ATS) minor criteria for severe community-acquired pneumonia (CAP) are of unequal weight. Whether the patients meeting three strongest predictive values have more severity and higher mortality is unclear. The purpose was to determine the speculations. Methods 171 adult severe CAP patients fulfilling three IDSA/ATS minor criteria were reviewed retrospectively. Results Hospital mortality rose sharply from 8.3%, 7.7% and 16.7%, respectively, for patients with other three minor criteria, one of the three strongest predictive values plus other two minor criteria and two of the three strongest predictive values plus another minor criterion to 33.3% for patients meeting the three strongest predictive values [Arterial oxygen pressure/fraction inspired oxygen (PaO2/FiO2) ≤ 250 mm Hg, confusion and uremia]. View this table: Table 1 Hospital mortality and the patterns of minor criteria The presence of three strongest predictive values was positively associated with sequential organ failure assessment (SOFA) scores and had a significant increased odds ratio for mortality of 4.500. Conclusions The presence of PaO2/FiO2 ≤ 250 mm Hg, confusion and uremia predicted more severity and mortalities in severe CAP patients meeting three IDSA/ATS minor criteria.