Korean J Crit Care Med.  2009 Dec;24(3):140-144. 10.4266/kjccm.2009.24.3.140.

Severe Health-care Associated Pneumonia among the Solid Cancer Patients on Chemotherapy

• Park MR
• Park SY
• Jeon K
• Koh WJ
• Chung MP
• Kim H
• Kwon OJ
• Suh GY
• Ahn JS
• Ahn MJ
• Lim HY

• KMID: 2228314
• DOI: http://doi.org/10.4266/kjccm.2009.24.3.140

Abstract

BACKGROUND: There are only inadequate studies on the characteristics of severe pneumonia in the patients who have solid cancer and who are treated with cytotoxic chemotherapy and also on the usefulness of the various severity index scores.
METHODS
We retrospectively reviewed 31 patients who were treated with cytotoxic chemotherapy because of solid cancer and who were admitted to the medical ICU at Samsung Medical Center from April 2007 to August 2008.
RESULTS
The median age of the 31 patients was 64 years old (34-79). The types of solid cancer were lung cancer (19, 61.3%), gastroesophageal cancer (4, 12.9%), breast cancer (2, 6.5%), liver cancer (1, 3.2%), ovarian cancer (1, 3.2%) and other types of cancer (4, 12.9%). The hospital mortality rate was 64.5%. We were able to determine the pathogen of 19 (61.3%) patients; S. pneumoniae (6), S. aureus (3), Candida species (3), P. aeruginosa (2), K. pneumoniae (1), Pneumocystis jiroveci (1) and others (3). There were no statistically differences of the laboratory data and severity index scores (PSI, CURB-65, APACHE II, SOFA, SAPS 3) between the survivors and nonsurvivors, except the P/F ratio.
CONCLUSIONS
The hospital mortality rate of severe pneumonia in patients who had solid cancer and who received cytotoxic chemotherapy was high. The major pathogen was S. pneumoniae. The severity indexes for general pneumonia were not useful to these patients.

Keyword

adjuvant chemotherapy; immunocompromised host; mortality; pathogens; pneumonia; severity of illness index

MeSH Terms

APACHE
Breast Neoplasms
Candida
Chemotherapy, Adjuvant
Hospital Mortality
Humans
Immunocompromised Host
Liver Neoplasms
Lung Neoplasms
Ovarian Neoplasms
Pneumocystis jirovecii
Pneumonia
Retrospective Studies
Severity of Illness Index
Survivors