Risk Factor Analysis of Acute Respiratory Distress Syndrome Among Hospitalized Patients with Chlamydophila pneumoniae Pneumonia

BackgroundChlamydophila pneumoniae (C. pneumoniae) pneumonia-associated acute respiratory distress syndrome (ARDS) is rare and has been seldom reported, but the outcome is usually fatal. This study was designed to identify the risk factors for hospitalized C. pneumoniae patients developing ARDS and to describe the outcomes.MethodsA retrospective study was performed to evaluate hospitalized patients over 18 years old diagnosed with C. pneumoniae pneumonia in a tertiary medical center.ResultsEleven patients who fulfilled the diagnostic criteria were included in this study. ARDS developed in 6 of 11 patients and mostly within 7 days of admission. Five of 6 patients needed to be transferred to the intensive care unit, and all of these patients died. The patients who developed ARDS had higher initial Acute Physiology and Chronic Health Evaluation II scores and CURB-65 (confusion, urea, respiratory rate, blood pressure, age) scores. The risk factors for developing ARDS included age ≥ 75 years, comorbid disease such as congestive heart failure, diabetes or liver cirrhosis, APACHE II score ≥ 12, CURB-65 score ≥ 2, white blood cell count > 12,000/mm3 or < 4,000/mm3, serum creatinine ≥ 1.4 mg/dL, and bilateral or multilobar involvement.ConclusionC. pneumoniae associated with ARDS has a higher mortality, and several risk factors, such as older age, underlying comorbidity and bilateral or multilobar involvement, should be identified earlier.