Incidence, risk factors and prognostic impact of severe community-acquired pneumonia complications’ in ICU: An observational cohort study

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Published Jul 12, 2026
https://doi.org/10.62438/tunismed.v104i07.6633
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Vol. 104 No. 07 (2026): Tunis Med Jul 2026

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Asma Mehdi
Medical Intensive Care Unit,University hospital of la Rabta, Faculty of Medicine of Tunis , University of Tunis El Manar , Tunis, Tunisia
Meriem Cherif
Medical Intensive Care Unit,University hospital of la Rabta, Faculty of Medicine of Tunis , University of Tunis El Manar , Tunis, Tunisia
Noussair Azzouz
Medical Intensive Care Unit,University hospital of la Rabta, Faculty of Medicine of Tunis , University of Tunis El Manar , Tunis, Tunisia
Eya Seghir
Medical Intensive Care Unit,University hospital of la Rabta, Faculty of Medicine of Tunis , University of Tunis El Manar , Tunis, Tunisia
Linda Messaoud
Medical Intensive Care Unit,University hospital of la Rabta, Faculty of Medicine of Tunis , University of Tunis El Manar , Tunis, Tunisia
Asma Ouhibi
Medical Intensive Care Unit,University hospital of la Rabta, Faculty of Medicine of Tunis , University of Tunis El Manar , Tunis, Tunisia
Ahlem Trifi
Medical Intensive Care Unit,University hospital of la Rabta, Faculty of Medicine of Tunis , University of Tunis El Manar , Tunis, Tunisia
Sami Abdellatif
Medical Intensive Care Unit,University hospital of la Rabta, Faculty of Medicine of Tunis , University of Tunis El Manar , Tunis, Tunisia

Abstract

Background: Severe -Community-Acquired-Pneumonia (SCAP) is a public health concern. It is characterised by a dynamic profile leading to secondarily complicated forms. SCAP complications are under-studied in ICU while linked to mortality and healthcare costs. We hypothesize that
SCAP complications are common in ICU and that they may be avoidable thru some clinical and paraclinical indicators.Thus, we aim to study the incidence, risk factors and prognostic impact of these complications in a Tunisian ICU.
Methods: It was an observational cohort study conducted over a period of two years in a Tunisian ICU.All patients admitted for a SCAP were included.The occurrence of complications was followed.Factors associated with these complications were analysed through a logistic regression
analysis. Survival analysis was processed using the Kaplan-Meier curves linked with the Log-rank test.
Results: SCAP complications occurred in 78% of cases. The main local complications were ARDS(N=61) and pulmonary abscess(N=15).The main
systemic ones were cardiovascular complications(N=151),acute kidney injury (N=131),septic shock(N=93) and sepsis-associated encephalopathy
(N=98).Klebsiella pneumoniae was isolated in 54 cases. Multivariate analysis showed that a SOFA score≥ 2.5(OR=5.57 [2.86-10.83]; p=0.000), SMART- COP score ≥4.5 (OR=2.18 [1.09-4.35]; p=0.027),COPD history(OR=3.64 [1.73-7.66]; p=0.001) and age≥68 years(OR=1.03 [1.011.05];p=0.001) were significantly linked to CAP complications. These were independently linked to mortality (OR=8.59; 95% CI [3.21-22.9];p=0,003).Survival analyses
showed that the concomitant occurrence of both systemic and local complications decreased the survival delay time by an average of 15 days when compared to un-complicated patients
Conclusions: Complications of SCAP are common in ICU with a dynamic ...(abstract truncated at 250 words).

Keywords:

Severe, Community, Pneumonia, Complications, Risk Factors, Mortality, ICU, Prognosis

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