Assessment of Mortality Predictors in Patients with Severe Community-acquired Pneumonia Requiring ICU Admission
Community-acquired pneumonia (CAP) is a prominent cause of death in the United States. It’s critical to understand the pathogen patterns that cause severe CAP.
The goal of this prospective study was to determine predictors of mortality and describe patient characteristics, mortality rates, and etiological infections in patients with severe CAP who required ICU hospitalisation.
Patients and Methods: From October 2012 to August 2015, this was a multicenter prospective observational study of 57 consecutive patients admitted to the ICU with a diagnosis of severe CAP.
The experiment had 57 people in total, with a 49.1% overall ICU death rate. Heart disease and chronic obstructive pulmonary disease were the most common comorbidities linked with severe CAP. Mortality was associated with old age (P=0.01), low diastolic blood pressure (P=0.04), low PaO2/FiO2 (P=0.04), high acute physiology and chronic health evaluation II (APACHE II) score (P=0.001), (CURB-65) score (P=0.005), low haemoglobin (P=0.008), and high urea (P=0.04) when survivors and non-survivors were compared. The following factors were found to be predictors of mortality in the univariate analysis: age greater than 65 years (P=0.03); APACHE II score greater than 20 (P=0.007); CURB-65 of 3 or greater (0.03); total leukocyte count less than 4 or greater than 11109/(P=0.04); PaO2/FiO2 less than 250 (P=0.03); serum urea greater than 30 mg/dl (P=0.04); presence of The use of multiple regression analysis was discovered. Septic shock and a high APACHE II score (>20) as major independent predictors of mortality in severe CAP. Microbiological identification was obtained in 52.6 percent of patients, with positive blood cultures in 17.5 percent. The pathogens most frequently isolated were Streptococcus pneumoniae (S. pneumoniae) (19.3%) and Staphylococcus aureus (S. aureus) (15.8 percent).
Conclusion: As documented by the majority of prior research, the mortality rate in patients with severe CAP was high. Death was predicted by both septic shock and a high APACHE II score. Cardiovascular illness and chronic obstructive pulmonary disease were the most common comorbidities. In 52.6 percent of cases, microbiological identification was obtained, with S. pneumoniae and S. aureus being the most frequently isolated pathogens.
Ali O. Abdel Aziz
Department of Chest Diseases, Faculty of Medicine, Minia University, Minya, Egypt
Mohammad T. Abdel Fattah
Department of Chest Diseases, Faculty of Medicine, Minia University, Minya, Egypt.
Ahmed H. Mohamed
Department of Anesthesia, Faculty of Medicine, Minia University, Minya, Egypt.
Mohammad O. Abdel Aziz
Department of Internal Medicine, Faculty of Medicine, Minia University, Minya, Egypt.
Mohammed S. Mohammed
Department of Microbiology, Faculty of Medicine, Minia University, Minya, Egypt.