Clinical, epidemiological, and etiological profile of inpatients with community-acquired pneumonia in a public hospital in the interior of Brazil

Abstract

Objective:To describe the patient profile, mortality rates, the accuracy of prognostic scores, and mortality-associated factors in patients with community-acquired pneumonia (CAP) in a general hospital in Brazil. Methods:This was a cohort study involving patients with a clinical and laboratory diagnosis of CAP and requiring admission to a public hospital in the interior of Brazil between March 2014 and April 2015. We performed multivariate analysis using a Poisson regression model with robust variance to identify factors associated with in-hospital mortality. Results:We included 304 patients. Approximately 70% of the patients were classified as severely ill on the basis of the severity criteria used. The mortality rate was 15.5%, and the ICU admission rate was 29.3%. After multivariate analysis, the factors associated with in-hospital mortality were need for mechanical ventilation (OR: 3.60; 95% CI: 1.85-7.47); a Charlson Comorbidity Index score > 3 (OR: 1.30; 95% CI: 1.18-1.43); and a mental Confusion, Urea, Respiratory rate, Blood pressure, and age > 65 years (CURB-65) score > 2 (OR: 1.46; 95% CI: 1.09-1.98). The mean time from patient arrival at the emergency room to initiation of antibiotic therapy was 10 h. Conclusions: The in-hospital mortality rate of 15.5% and the need for ICU admission in almost one third of the patients reflect the major impact of CAP on patients and the health care system. Individuals with a high burden of comorbidities, a high CURB-65 score, and a need for mechanical ventilation had a worse prognosis. Measures to reduce the time to initiation of antibiotic therapy may result in better outcomes in this group of patients.

Charlson Comorbidity Index and other predictors of in-hospital mortality among adults with community-acquired pneumonia

“…CAP was the main reason for admission to the hospital, with a mortality rate of approximately 15.5%. 18 At the time the present study was conducted, the hospital was beginning to implement the use of severity indices to assess the need for admission in patients seeking the ER. The health care professionals in charge of collecting standardized data to calculate the indices were trained by the research team.…”

“…A PAC foi o principal motivo de internação hospitalar, com taxa de mortalidade de aproximadamente 15,5%. (18) Quando o presente estudo foi realizado, o hospital estava começando a usar índices de gravidade para avaliar a necessidade de internação em pacientes que buscavam o PS. Os profissionais de saúde responsáveis pela coleta de dados padronizados para o cálculo dos índices foram treinados pelo grupo de pesquisa.…”

Prognosis of COVID-19 Pneumonia Can Be Early Predicted Combining Age-Adjusted Charlson Comorbidity Index, CRB Score and Baseline Oxygen Saturation.

“…[25] Generally, both components have been studied as alternatives, [26] and rarely as complementary. [27,28] In patients with COVID-19, Petrilli [29] and ISARIC [18,30] are two groups that more closely resemble this study's objective. Petrilli does not explicitly include a comorbidity scale but empirically reaches the same conclusions: age, comorbidity, oxygenation and in ammation parameters determine the need for hospitalisation and the development of severe disease; the relative weight of each possibly varies depending on the outcome and the population of interest.…”

Cell population data in identifying active tuberculosis and community-acquired pneumonia

“…Globally, pneumonia is a serious public health concern and a major cause of mortality and morbidity [ 8 ]. In recent years, with the aging of the population, the abuse of antibacterial drugs, the increase in immune damage, and the changes in the human living environment have led to great difficulty in the diagnosis and treatment of pneumonia [ 9 , 10 , 11 , 12 ]. Rapid and accurate diagnosis, timely treatment and management of the patients, and proper use of antibiotics need urgent attention.…”