Risk factors associated with respiratory failure among hospitalized pneumonia patients in Kanchanadit Hospital, Suratthani
Keywords:
pneumonia, respiratory failure, risk factorsAbstract
Introduction: Pneumonia is the most leading cause of death in community hospital especially complicated with respiratory failure. To explore the patients with the high risk of developing respiratory failure for close monitoring in critical care unit and management to prevent future endotracheal tube insertion is important. However, there are only few studies about risk factors associated with respiratory failure in pneumonia. Thus, this study aimed to evaluate risk factors associated with respiratory failure in hospitalized pneumonia patients.
Objective: To identify the risk factors associated with respiratory failure in hospitalized pneumonia patients.
Methods: A retrospective cohort study of adults with hospitalized pneumonia in Kanchanadit Hospital was conducted between January 2016 and December 2017. All hospitalized patients with principal diagnosis of bacterial pneumonia, codes (International Classification of Diseases, Tenth Revision code [ICD-10]) J13 to J18 were included. We collected clinical and laboratory information from inpatient medical records, reviewed first chest X-rays [CXR] performed on admission, and compared those variables to evaluate risk factors associated with respiratory failure using multivariable logistic regression analysis.
Results: A total of 353 patients were diagnosed with pneumonia, 85 (24.1%) had respiratory failure. Risk factors significantly associated with developing respiratory failure were bilateral or multilobar infiltrations on CXR (adjusted Odds Ratio [aOR] 4.52, 95% confidence interval [CI] 2.39-8.56, P < 0.001), oxygen saturation < 90% (aOR 4.28, 95% CI 1.89-9.71, P = 0.001), pulse rate ≥ 125 beats/minute (aOR 4.12, 95% CI 1.69-10.03, P = 0.002), atrial fibrillation (aOR 3.76, 95% CI 1.17-12.14, P = 0.026), pleural effusion on CXR (aOR 2.82, 95% CI 1.22-6.48, P = 0.015), serum creatinine ≥1.2 mg/dl (aOR 2.38, 95% CI 1.13-4.99, P = 0.022) and body temperature ≥ 38 ºC (aOR 0.47, 95% CI 0.24-0.93, P = 0.030).
Conclusion: Prevalence of respiratory failure in pneumonia in Kanchanadit Hospital was high. Fever, tachycardia, oxygen desaturation, atrial fibrillation, renal insufficiency and CXR found
bilateral/multilobar infiltration or pleural effusion were significant risk factors associated with respiratory failure.
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