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Finally, chronic illnesses are additional risk factors for the development of PHL, as there are patients with one or more underlying chronic diseases requiring long-term hemodialysis in our hospital. In previous studies, coexisting chronic illness was an independent risk factor for PHL \[[@B23],[@B28]-[@B30]\]. Generally, about 20% of patients admitted to the ICU had one or more chronic diseases \[[@B1]\]. Chronic illnesses that were reported to be related to PHL included diabetes mellitus, chronic obstructive pulmonary disease, coronary heart disease and human immunodeficiency virus.
PHL has been identified as a major nosocomial complication of CAP for more than four decades. More than 80% of cases of CAP-related PHL occur in patients who are hospitalized for CAP \[[@B1]\]. The overall incidence of PHL in patients with CAP is reported to range from 4.5 to 28% in previous studies \[[@B1],[@B21],[@B31]-[@B34]\]. Additionally, most studies suggested that the risk of PHL was similar in patients with CAP hospitalized in the ward and ICU, and the ICU-hospitalized patients were also considered to have a longer ICU-
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