ลักษณะทางคลินิกของผู้ป่วยโรคปอดอักเสบชุมชนในโรงพยาบาลพระจอมเกล้า จังหวัดเพชรบุรี

บทคัดย่อ

Objectives : To evaluate clinical features, etiology and outcome of adult patients hospitalized with com-munity-acquired pneumonia at Phrachomklao Hospital.

Materials and methods : Retrospective study of immunocompetent patients over 14 years old hos-pitalized with community-acquired pneumonia between 1^st  January and 31^st  December 2008 was done by reviewing medical records.

Results : One hundred and ninety three patients were included. Male to female ratio was 3.3 : 1 and mean age was 68.3 years (S.D. 15.9). Most of them (88.1%) had co-morbidity (chronic obstructive pulmonary disease, chronic kidney disease and cardiovascular disease). The most common clinical features were dyspnea (87.0%), cough (70.5%) and fever (63.2%). The causative organisms were identified by sputum examination in 68 patients (35.2%). Klebsiella pneumoniae was the commonest pathogen (9.8%), followed by Acineto-bacter baumannii (6.2%), Pseudomonas aeruginosa (5.2%) and Escherichia coli (5.2%). Hospital length of stay averaged at 8.26 days (S.D. 6.5) and mortality rate was 25.4%. The most common complications were acute respiratory failure (34.7%) and septicemic shock (17.6%).

Conclusion : To optimize the outcome and mortality rate from community-acquired pneumonia, clinical diagnosis and risk stratification are needed. Rapid start of appropriate antibiotics using local sensitivity infor-mation and supportive care are the mainstay of management.