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Community-acquired Pneumonia: A Potentially Lethal Emergency?

Peralta, Rogelio MD*; Polverino, Eva MD, PhD*,†; Rinaudo, Mariano MD*; Loureiro, Hugo MD*; Terraneo, Silvia MD*; Torres, Antoni MD, PhD*,†

doi: 10.1097/CPM.0b013e318299120c
Respiratory Infections

Community-acquired pneumonia (CAP) is a major health problem with a very high prevalence and mortality. Mortality can reach 13% among hospitalized patients and nearly 50% in the long term (5 y). Similarly, acute coronary syndrome is a life-threatening condition for which clinical management has greatly improved because of effective protocols of prehospital care and evidence-based interventions in the hospital, within well-defined timescales. Unfortunately, CAP management cannot be compared with that of acute coronary syndrome in terms of risk stratification and action protocols. In fact, CAP continues to be the main cause of severe sepsis in hospitalized patients; early evaluation is fundamental, especially in the first 24 hours, when mortality is high. Current risk-stratification tools for CAP are designed primarily to predict mortality and identify low-risk patients, which is valuable for ambulatory treatment, whereas the detection of high-risk patients remains suboptimal. Recent attempts to improve predictive tools, with the development of new biomarkers and alternative scoring systems, are discussed.

*Pulmonary Department, Pulmonary Critical Care Unit, Thorax Institute, Hospital Clínic

Centro de Investigación Biomédica En Red-Enfermedades Respiratorias (CIBERES), IDIBAPS, Barcelona, Spain

The authors declare that they have nothing to disclose.

Address correspondence to: Antoni Torres, MD, Pulmonary Critical Care Unit, Hospital Clinic, Calle Villarroel 170, Esc 6/8 Planta 2, 08036 Barcelona, Spain. E-mail:

© 2013 by Lippincott Williams & Wilkins, Inc.