Hastaneye Yatış Gerektiren Toplum Kökenli Pnömoni Olgularında Mortalite Oranı ve Etkileyen Faktörler

Year 2021, Volume: 4 Issue: 1, 15 - 21, 01.03.2021

Mutlu Kuluöztürk Gülden Eser Gökçen Ağaoğlu Figen Deveci

Abstract

Aim: To determine the mortality rate and affecting factors in patients with community-acquired pneumonia (CAP) requiring hospitalization.
Method: 150 patients with CAP retrospectively evaluated. Age, gender, hospital mortality, presence of concomitant disease, smoking history, history of intensive care unit and invasive mechanical ventilation, hospitalization time, arterial oxygen saturation (SaO2), CURB-65 score, sputum culture results, values of pulse, arterial blood pressure, fever, respiratory rate, confusion status, hemogram, urea, creatinine, CRP and procalcitonin (PCT) values were recorded from our hospital’s database system.
Results: The hospital mortality rate was 12.7% (n = 19). The mean age, CURB65 scores, fewer, respiratory rate, neutrophil counts, urea, CRP levels and PCT positivity were statistically increased and SaO2 levels, systolic TA, diastolic TA, lymphocytes and platelet counts were statistically decreased in CAP patients with died in-hospital. Logistic regression showed that need for invasive mechanical ventilation, confusion status and PCT positivity were significantly associated with in-hospital mortality.
Conclusion: Advanced age, high neutrophil ratio, high CURB-65 score and low systolic TA values are related factors with hospital mortality in patients with CAP requiring hospitalization. In addition, invasive mechanical ventilation, confusion status and PCT positivity are independent risk factors for hospital mortality in CAP patients.

Keywords

Community Acquired Pneumonia, Mortality, CURB-65

Supporting Institution

yok

References

• Referans 1. Musher DM, Thorner AR. Community acquired pneumonia. N Engl J Med 2014; 371: 1619–28.
• Referans2. Kolditz M, Tesch F, Mocke L, et al. Burden and risk factors of ambulatory or hospitalized CAP: a population based cohort study. Respir Med 2016; 121: 32–8.
• Referans3. Breitling LP, Saum KU, Schottker B, et al. Pneumonia in the noninstitutionalized older population. Dtsch Arztebl Int 2016; 113: 607–14.
• Referans4. Ewig S, Birkner N, Strauss R, et al. New perspectives on community-acquired pneumonia in 388 406 patients. Results from a nationwide mandatory performance measurement programme in healthcare quality. Thorax 2009; 64: 1062–9.
• Referans5. Corrales-Medina VF, Musher DM, Wells GA, et al. Cardiac complications in patients with communityacquired pneumonia: incidence, timing, risk factors, and association with short-term mortality. Circulation 2012; 125: 773–81.
• Referans6. Dremsizov T, Clermont G, Kellum JA, et al. Severe sepsis in community-acquired pneumonia: when does it happen, and do systemic inflammatory response syndrome criteria help predict course? Chest 2006; 129: 968–78.
• Referans7. Phua J, Ngerng WJ, Lim TK. The impact of a delay in intensive care unit admission for community-acquired pneumonia. Eur Respir J 2010; 36: 826–33.
• Referans8. T.C. Sağlık Bakanlığı, Refik Saydam Hıfzıssıhha Merkezi Başkanlığı Hıfzıssıhha Mektebi Müdürlüğü, Başkent Üniversitesi Ulusal Hastalık Yükü ve Maliyeti Etkinlik Projesi, 2004 (www.toraks.org.tr).
• Referans9. Türkiye İstatisitik Kurumu, Sağlık İstatistikleri (http://www.tuik.gov.tr).
• Referans10. Özlü T, Bülbül Y, Özsu S. Ulusal Verilerle Toplumda gelişen pnömoniler. Tüberküloz ve Toraks Dergisi 2007; 55: 191-212.
• Referans11. US Food and Drug Administration. Guidance for industry: community-acquired bacterial pneumonia: developing drugs for treatment. MD, USA: Silver Spring; 2014.
• Referans12. Viasus D, Cillóniz C, Cardozo CG, et al. Early, short and long-term mortality in community-acquired pneumonia. Ann Res Hosp 2018; 2: 5.
• Referans13. Garcia-Vidal C, Fernández-Sabé N, Carratalà J, et al. Early mortality in patients with community-acquired pneumonia: causes and risk factors. Eur Respir J 2008; 32: 733-9.
• Referans14. Mortensen EM, Restrepo MI, Anzueto A, Pugh JA. Antibiotic therapy and 48-hour mortality for patients with pneumonia. Am J Med 2006; 119: 859-64.
• Referans15. Fine MJ, Smith MA, Carson CA, et al. Prognosis and outcomes of patients with community-acquired pneumonia. A meta-analysis. JAMA 1996; 275: 134-41.
• Referans16. Bacci MR, Leme RC, Zing NP, et al. IL-6 and TNF-α serum levels are associated with early death in community acquired pneumonia patients. Braz J Med Biol Res 2015; 48: 427-32.
• Referans17. Baek MS, Park S, Choi JH, Kim CH, Hyun IG. Mortality and Prognostic Prediction in Very Elderly Patients With Severe Pneumonia. J Intensive Care Med 2020; 35:1405-10.
• Referans18. Williams JM, Greenslade JH, Chu KH, et al. Utility of community-acquired pneumonia severity scores in guiding disposition from the emergency department: Intensive care or short-stay unit? Emerg Med Australas 2018; 30: 538-46.
• Referans19. Loke YK, Kwok CS, Niruban A, Myint PK. Value of severity scales in predicting mortality from community-acquired pneumonia: systematic review and meta-analysis. Thorax 2010; 65: 884-90.
• Referans20. Viasus D, Del Rio-Pertuz G, Simonetti AF, et al. Biomarkers for predicting short-term mortality in community-acquired pneumonia: a systematic review and meta-analysis. J Infect 2016; 72: 273–82.
• Referans21. Fernandez JF, Sibila O, Restrepo MI. Predicting ICU admission in community-acquired pneumonia: clinical scores and biomarkers. Expert Rev Clin Pharmacol 2012; 5: 445–58.
• Referans22. Siljan WW, Holter JC, Michelsen AE, et al. Inflammatory biomarkers are associated with aetiology and predict outcomes in community-acquired pneumonia: results of a 5-year follow-up cohort study. ERJ Open Res 2019; 5: 00014-2019.
• Referans23. Peñafiel Fs, O'Brien Solar A, et al. Community-Acquired Pneumonia Requiring Hospitalization in Immunocompetent Elderly Patients: Clinical Features, Prognostic Factors and Treatment. Arch Bronconeumol 2003; 39: 333-40.
• Referans24. Bruns AH, Oosterheert JJ, Cucciolillo MC, et al. Cause specific long-term mortality rates in patients recovered from community-acquired pneumonia as compared with the general Dutch population. Clin Microbiol Infect 2011; 17: 763-8.
• Referans25. Adamuz J, Viasus D, Jiménez-Martínez E, et al. Incidence, timing and risk factors associated with 1-year mortality after hospitalization for community-acquired pneumonia. J Infect 2014; 68: 534-41.
• Referans26. Mortensen EM1, Kapoor WN, Chang CC, Fine MJ. Assessment of mortality after long-term follow-up of patients with community-acquired pneumonia. Clin Infect Dis 2003; 37: 1617-24.
• Referans27. Akyil FT, Yalcinsoy M, Hazara A, et al. Prognosis of hospitalized patients with community-acquired pneumonia. Pulmonol 2018; 24: 164-69.