Risk Factors for Mortality in Community-Acquired Pneumonia Patients Admitted to a Referral Hospital / 결핵및호흡기질환

ABSTRACT

BACKGROUND: Pneumonia is the most common cause of death among infectious diseases with community-acquired pneumonia being the sixth leading cause of death in the USA. In Korea, several studies have evaluated the prognosis of community-acquired pneumonia with a limited number of patients and risk factors. This study, evaluated all the possible risk factors (including the pneumonia severity index; PSI) in for the community-acquired pneumonia patients admitted to a referral hospital. METHODS: The medical records of patients admitted to the Chung-Aug University Yongsan Hospital between January 2002 and January 2005 for community-acquired pneumonia were reviewed retrospectively. The demographic data, comorbidity, radiographic findings and laboratory results which might influence the prognosis of pneumonia were analyzed. RESULTS: Among 179 patients admitted for community-acquired pneumonia, 29 patients died (mortality 16%). The risk factors for mortality in the comorbidity category were congestive heart failure and a myocardial infarction. The laboratory data, showed that albumin, LDH, total cholesterol, HDL, PT, aPTT, hemoglobin and blood urea nitrogen (BUN) were related to the prognosis. For the pneumonia severity index, the mortality rate increased in a step-wise manner from class I through class V. CONCLUSIONS: Comorbidities such as congestive heart failure and myocardial infarction as well as the albumin, LDH, total cholesterol, HDL cholestreol, prothrombin time, activated partial thrombotin time, hemoglobin and blood urea nitrogen(BUN) are important risk factors for mortality in patients with community-acquired pneumonia. PSI is a valuable index for evaluating the prognosis of community-acquired pneumonia.