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

Lee, Young Woo (Department of Internal Medicine, Chung Ang University College of Medicine)
Jung, Jae Woo (Department of Internal Medicine, Chung Ang University College of Medicine)
Song, Ju Han (Department of Internal Medicine, Chung Ang University College of Medicine)
Jeon, Eun Ju (Department of Internal Medicine, Chung Ang University College of Medicine)
Choi, Jae Cheol (Department of Internal Medicine, Chung Ang University College of Medicine)
Shin, Jong Wook (Department of Internal Medicine, Chung Ang University College of Medicine)
Kim, Jae Yeol (Department of Internal Medicine, Chung Ang University College of Medicine)
Park, In Won (Department of Internal Medicine, Chung Ang University College of Medicine)
Choo, Byoung Whui (Department of Internal Medicine, Chung Ang University College of Medicine)
Publication Information
Tuberculosis and Respiratory Diseases / v.61, no.4, 2006 , pp. 347-355 More about this Journal
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.
Keywords
Community-acquired pneumonia; Risk factor; Mortality; PSI;
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1 Fine MJ, Auble TE, Yealy DM, Hanusa BH, Weissfeld LA, Singer DE, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med 1997:336:243-50   DOI   ScienceOn
2 Ortqvist A, Sterner G, Nilsson JA. Severe community-acquired pneumonia: factors influencing need of intensive care treatment and prognosis. Scand J Infect Dis 1985:17:377-86
3 Choi WI, Sohn JH, Kwun OY, Heo JS, Whang JS, Han SB, et al. Clinical manifestation of patients dying of severe community acquired pneumonia. Tuberc Respir Dis 1994:41:537-45   DOI
4 Loh LC, Khoo SK, Quah SY, Visvalingam V, Radhakrishnan A, Vijayasingham P, et al. Adult community-acquired pneumonia in Malaysia: prediction of mortality from severity assessment on admission. Respirology 2004:9:379-86   DOI   ScienceOn
5 Moshage HJ, Janssen JA, Franssen JH, Hafkenscheid JC, Yap SH. Study of the molecular mechanism of decreased liver synthesis of albumin in inflammation. J Clin Invest 1987:79:1635-41   DOI
6 Klar A, Shoseyov D, Berkun Y, Brand A, Braun J, Shazberg G, et al. Intestinal protein loss and hypoalbuminemia in children with pneumonia. J Pediatr Gastroenterol Nutr 2003:37:120-3   DOI   ScienceOn
7 Wilkes MM, Navickis RJ. Patient survival after human albumin administration: a meta-analysis of randomized, controlled trials. Ann Intern Med 2001:135:149-64   DOI   ScienceOn
8 The British Thoracic Society and the Public Health Laboratory Service. Community-acquired pneumonia in adults in British hospitals in 1982-1983: a survey of aetiology, mortality, prognostic factors and outcome. Q J Med 1987:62:195-220
9 Ballmer PE. Causes and mechanisms of hypoalbuminaemia. Clin Nutr 2001:20:271-3   DOI   ScienceOn
10 Park HP, Seo YW, Lee JE, Kim YH, Jang YY, Park SH, et al. Factors associated with early death in patients with community-acquired pneumonia. Tuberc Respir Dis 2005:58:607-13   DOI
11 Porat S, Bhatia N, Barnett DW. A child with severe pneumonia, pleural effusion and acute hypoalbuminemia. Clin Pediatr 2002:41:199-200   DOI   ScienceOn
12 Drent M, Cobben NA, Henderson RF, Wouters EF, van Dieijen-Visser M. Usefulness of lactate dehydrogenase and its isoenzymes as indicators of lung damage or inflammation. Eur Respir J 1996:9:1736-42   DOI   ScienceOn
13 Sankaran RT, Mattana J, Pollack S, Bhat P, Ahuja T, Patel A, et al. Laboratory abnormalities in patients with bacterial pneumonia. Chest 1997:111:595-600   DOI
14 Leeper KV Jr, Torres A. Community-acquired pneumonia in the intensive care unit. Clin Chest Med 1995:16:155-71
15 Fine MJ, Stone RA, Singer DE, Coley CM, Marrie TJ, Lave JR, et al. Processes and outcomes of care for patients with community-acquired pneumonia: results from the Pneumonia Patient Outcomes Research Team (PORT) cohort study. Arch Intern Med 1999:159:970-80   DOI   ScienceOn
16 Watari M, Ohe M, Kunimoto E, Tsukamoto R, Komagata H. Mortality and prognostic factors in patients with community-acquired pneumonia: an analysis of 231 cases. Nihon Kokyuki Gakkai Zasshi 2000:38: 509-17
17 Ortqvist A. Initial investigation and treatment of the patient with severe community-acquired pneumonia. Semin Respir Infect 1994:9:166-79
18 Jinks MF, Kelly CA. The pattern and significance of abnormal liver function tests in community-acquired pneumonia. Eur J Intern Med 2004:15:436-40   DOI   ScienceOn
19 Alderson P, Bunn F, Lefebvre C, Li WP, Li L, Roberts I, et al. Human albumin solution for resuscitation and volume expansion in critically ill patients. Cochrane Database Syst Rev 2004:CD001208
20 Cochrane Injuries Group Albumin Reviewers. Human albumin administration in critically ill patients: systematic review of randomised controlled trials. BMJ 1998:317:235-40   DOI
21 Hedlund JU, Hansson LO, Ortqvist AB. Hypoalbuminemia in hospitalized patients with communityacquired pneumonia. Arch Intern Med 1995:155:1438-42   DOI   ScienceOn
22 Menendez R, Ferrando D, Valles JM, Martinez E, Perpina M. Initial risk class and length of hospital stay in community-acquired pneumonia. Eur Respir J 2001:18:151-6.   DOI   ScienceOn
23 Liao WS, Jefferson LS, Taylor JM. Changes in plasma albumin concentration, synthesis rate, and mRNA level during acute inflammation. Am J Physiol 1986:251:C928-34
24 Deniz O, Tozkoparan E, Yaman H, Cakir E, Gumus S, Ozcan O, et al. Serum HDL-C levels, log (TG/HDL-C) values and serum total cholesterol/ HDL-C ratios significantly correlate with radiological extent of disease in patients with community-acquired pneumonia. Clin Biochem 2006:39:287-92.   DOI   ScienceOn
25 Oh HK, Seo JY, Kim DK, Choi JE, Mo EK, Park MJ, et al. Clinical characteristics and prognostic factors of severe community-acquired pneumonia. Tuberc Respir Dis 1997:44:1072-82   DOI
26 Halm EA, Teirstein AS. Clinical practice: management of community-acquired pneumonia. N Engl J Med 2002:347:2039-45   DOI
27 Pachon J, Prados MD, Capote F, Cuello JA, Garnacho J, Verano A. Severe community-acquired pneumonia: etiology, prognosis, and treatment. Am Rev Respir Dis 1990:142:369-73   DOI   ScienceOn
28 Bunn F, Lefebvre C, Li Wan Po A, Li L, Roberts I, Schierhout G. Human albumin solution for resuscitation and volume expansion in critically ill patients. The Albumin Reviewers. Cochrane Database Syst Rev 2000:CD001208.