• Clin Respir J · Apr 2020

    Observational Study

    Factors predicting in-hospital mortality among patients admitted with community acquired pneumonia at a tertiary care hospital Karachi, Pakistan.

    • Nousheen Iqbal, Muhammad Irfan, Faraz Siddique, Verda Arshad, and Zubairi Ali Bin Sarwar ABS https://orcid.org/0000-0002-0874-638X Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan Uni.
    • Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.
    • Clin Respir J. 2020 Apr 1; 14 (4): 328-334.

    IntroductionCommunity Acquired Pneumonia (CAP) is associated with significant morbidity and mortality globally, but unfortunately there is limited data available from South East Asia.ObjectiveTo determine the risk factors associated with in-hospital mortality in patients with CAP in a tertiary care hospital of Pakistan.MethodsA retrospective study was conducted on adult patients admitted with a diagnosis of CAP from January 2011 till December 2016. Their clinical records were reviewed and a multivariable analysis was done to determine the factors associated with in-hospital mortality.ResultsA total of 1100 files were reviewed, of which 509 were included in the analysis. The mean age was 63.6 ± 16.5 years and 302 (52.16%) were males. The most Common isolated pathogen was Staphylococcus aureus (23%). Overall mortality was 10.8%. On univariate analysis factors associated with mortality were old age patients (P = 0.02); history of pneumonia in last 12 months (P = 0.008); CURB 65 score ≥ 3 (P < 0.001) and high dependency units as initial site of care (P < 0.001). On multivariable analysis CURB65 ≥ 3 score; high dependency unit as initial site of care; bedridden status; presence of bilateral infiltrates on chest X-ray and hemoglobin of 10.4 g/dL or less at the time of admission were key determinants of in-hospital mortality.ConclusionWe found CURB65 ≥ 3 score; high dependency unit as initial site of care; bedridden status; bilateral infiltrates on chest X-ray and low hemoglobin (10.4 g/dL or less) at the time of admission as independent risk factors of in-hospital mortality. Staphylococcus aureus was the most common organism isolated in patients.© 2019 John Wiley & Sons Ltd.

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