Pulmonology Pulmonology
Pulmonol 2018;24:164-9 - Vol. 24 Num.3 DOI: 10.1016/j.rppnen.2017.07.010
Original article
Prognosis of hospitalized patients with community-acquired pneumonia
F. Tokgoz Akyila,, , M. Yalcinsoyb, A. Hazara, A. Cillic, B. Celenkc, O. Kilicd, A. Sayinere, N. Kokturkf, A. Sakar Coskung, A. Filizh, E. Cakir Edisi
a Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Chest Diseases, İstanbul, Turkey
b Inonu University, Faculty of Medicine, Department of Chest Diseases, Battalgazi/Malatya, Turkey
c Akdeniz University, Faculty of Medicine, Department of Chest Diseases, Konyaaltı/Antalya, Turkey
d Dokuz Eylul University, Faculty of Medicine, Department of Chest Diseases, Konak/İzmir, Turkey
e Ege University, Faculty of Medicine, Department of Chest Diseases, Bornova/İzmir, Turkey
f Gazi University, Faculty of Medicine, Department of Chest Diseases, Yenimahalle/Ankara, Turkey
g Celal Bayar University, Faculty of Medicine, Department of Chest Diseases, Yunusemre – Manisa, Turkey
h Gaziantep University, Faculty of Medicine, Department of Chest Diseases, Şehitkamil/Gaziantep, Turkey
i Trakya University, Faculty of Medicine, Department of Chest Diseases, İskender Köyü/Edirne Merkez/Edirne, Turkey
Received 07 February 2017, Accepted 13 July 2017
Abstract
Introduction

The long-term prognosis of patients with community-acquired pneumonia (CAP) has attracted increasing interest in recent years. The objective of the present study is to investigate the short and long-term outcomes in hospitalized patients with CAP and to identify the predictive factors associated with mortality.

Patients and methods

The study was designed as a retrospective, multicenter, observational study. Hospitalized patients with CAP, as recorded in the pneumonia database of the Turkish Thoracic Society between 2011 and 2013, were included. Short-term mortality was defined as 30-day mortality and long-term mortality was assessed from those who survived 30 days. Predictive factors for short- and long-term mortality were analyzed.

Results

The study included 785 patients, 68% of whom were male and the mean age was 67±16 (18–92). The median duration of follow-up was 61.2±11.8 (37–90) months. Thirty-day mortality was 9.2% and the median survival of patients surviving 30 days was 62.8±4.4 months. Multivariate analysis revealed that advanced age, the absence of fever, a higher Charlson comorbidity score, higher blood urea nitrogen (BUN)/albumin ratios and lower alanine aminotransferase (ALT) levels were all predictors of long-term mortality.

Conclusion

Long-term mortality following hospitalization for CAP is high. Charlson score and lack of fever are potential indicators for decreased long-term survival. As novel parameters, baseline BUN/albumin ratios and ALT levels are significantly associated with late mortality. Further interventions and closer monitoring are necessary for such subgroups of patients.

Keywords
Alanin aminotransferase, BUN/albumin, Charlson comorbidity score, Pneumonia, PSI score, Survival
Pulmonol 2018;24:164-9 - Vol. 24 Num.3 DOI: 10.1016/j.rppnen.2017.07.010
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