Clinical Aspects and Predictive Risk Factors for Mortality of Hospitalized Community-Acquired Pneumonia in U-thong Hospital: A Case-Control Study, Suphan Buri Province
Keywords:
community-acquired pneumonia, mortality, risk factor, severity assessmentAbstract
Community-acquired pneumonia (CAP) is one of the leading causes of death in U-thong Hospital. The in-hospital mortality of CAP is high and still burden. Because of the different severity and multiple factors of the patients, we need to assess and find the modifiable factors to improve management of CAP.
Method: A retrospective case-control study was conducted between June 2014 to December 2016. The 270 adult patients diagnosed of CAP were recruited. Demographic, clinical data, laboratory data and initial condition were collected and then analyzed and devided into two group, alive (n=220) and dead (n=50) group. The CURB-65 scores and PSI were used for assessment CAP-patients in both groups. The statistic analysis are frequency, percentage, mean, maximum and minimum value, t-test, chi-square test and logistic regression.
Result: The significant risk factors were ICU admission, sepsis, septic shock, respiratory failure, education level, and oxygen home therapy. The odds ratio of sepsis, septic shock and respiratory failure were 6.85, 9.88 and 56.31, respectively (p<0.001). ICU admission was associated with higher risk for mortality of CAP odds ratio 5.25 (95%CI 2.05-13.43: p<0.001). The education level and oxygen therapy at home were found to be the significant risk factors as well, but the odds ratio of alteration of consciousness was 1.36 (p=0.247) which was non-significant.
Conclusion: The risk factors that may be associated with mortality of community-acquired pneumonia were sepsis, septic shock, respiratory failure, ICU at admission, and oxygen home therapy. CURB-65 score and PSI could be used to improve initial assessment in U-thong Hospital.
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ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
