Identification of risk factors for lethal outcome in patients with severe community-acquired pneumonia

Abstract

Aim of the study. To determine clinical and biochemical parameters as risk factors for mortality in patients with severe community-acquired pneumonia. Material and methods. A prospective, parallel group analysis of patients with community-acquired pneumonia, treated at the Intensive Care Unit of the University Clinic for Infectious Diseases in period of one year. A total of 42 adults (>=18 years) were enrolled, who were divides in two groups according to the outcome; survived and deceased. The outcome was defined as survival or death during the 30-day hospital treatment. Demographic, clinical as well as laboratory parameters were evaluated in all patients on admission. A statistically significant finding was considered if p<0,05. Results: The average age of patients was 61+15.2 years, and 33 (78.6%) were males. The overall mortality was 50%. In 29 (69%) patients a comorbid condition was registered, and comorbidity showed a statistical significance regarding the outcome. All had tachycardia, tachypnea and hypotension on admission, but impaired consciousnesses and shock were associated with mortality. Patients who died had a higher leukocyte count (15.9+11.8x109/L), higher procalcitonin levels (43.9+77.3 mg/ml), higher serum glucose levels (11.4+6.2 mmol/L) and lower PaO2/Fi O2 (122.64+ 52.8). Hyperglycaemia and hypoxia were the biochemical parameters that showed a statistically significant difference between the two study groups. Conclusion: Early identification of the risk factors for lethal outcome in patients with severe community acquired pneumonia enables implementation of adequate therapeutic measures, thereby decreasing the mortality in this group of critically ill patients.