Canan Gündüz1, Mehmet Sezai Taşbakan2, Abdullah Sayıner2, Aykut Çilli3, Oğuz Kılınç4, Ayşın Şakar Coşkun5. 1. Department of Chest Diseases, Adıyaman University Training and Research Hospital, Adıyaman, Turkey. 2. Department of Chest Diseases, Faculty of Medicine, Ege University, İzmir, Turkey. 3. Department of Chest Diseases, Faculty of Medicine, Akdeniz University, Antalya, Turkey. 4. Department of Chest Diseases, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey. 5. Department of Chest Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
Abstract
BACKGROUND/AIM: Treatment failure in hospitalized patients with community-acquired pneumonia is a major cause of mortality. The aim of this study was to evaluate the factors affecting treatment success in community-acquired pneumonia. MATERIALS AND METHODS: A total of 537 patients (mean age: 66.1 ± 15.8 years, 365 males) registered to the Turkish Thoracic Society Pneumonia Database were analyzed. Of these, clinical improvement or cure, defined as treatment success, was achieved in 477, whereas 60 patients had treatment failure and/or died. RESULTS: Lower numbers of neutrophils (5989.9 ± 6237.3 vs. 8495.6 ± 7279.5/mm3), higher blood urea levels (66.1 ± 42.1 vs. 51.2 ± 38.2 mg/dL), higher Pneumonia Severity Index (PSI) scores (123.3 ± 42.6 vs. 96.3 ± 32.9), higher CURB-65 scores (2.7 ± 1.2 vs. 2.2 ± 0.9), lower PaO2/FiO2 ratios (216.3 ± 86.8 vs. 269.9 ± 65.6), and the presence of multilobar (33.3% vs. 16.4%) and bilateral (41.7% vs. 18.9%) radiologic infiltrates were related to treatment failure. The PSI score and PaO2/FiO2 ratio were independent parameters affecting treatment results in multivariate linear regression analysis (P < 0.001). CONCLUSION: The risk of treatment failure is high in patients with severe pneumonia and with respiratory failure. Effective treatment and close monitoring are required for these cases.
BACKGROUND/AIM: Treatment failure in hospitalized patients with community-acquired pneumonia is a major cause of mortality. The aim of this study was to evaluate the factors affecting treatment success in community-acquired pneumonia. MATERIALS AND METHODS: A total of 537 patients (mean age: 66.1 ± 15.8 years, 365 males) registered to the Turkish Thoracic Society Pneumonia Database were analyzed. Of these, clinical improvement or cure, defined as treatment success, was achieved in 477, whereas 60 patients had treatment failure and/or died. RESULTS: Lower numbers of neutrophils (5989.9 ± 6237.3 vs. 8495.6 ± 7279.5/mm3), higher blood urea levels (66.1 ± 42.1 vs. 51.2 ± 38.2 mg/dL), higher Pneumonia Severity Index (PSI) scores (123.3 ± 42.6 vs. 96.3 ± 32.9), higher CURB-65 scores (2.7 ± 1.2 vs. 2.2 ± 0.9), lower PaO2/FiO2 ratios (216.3 ± 86.8 vs. 269.9 ± 65.6), and the presence of multilobar (33.3% vs. 16.4%) and bilateral (41.7% vs. 18.9%) radiologic infiltrates were related to treatment failure. The PSI score and PaO2/FiO2 ratio were independent parameters affecting treatment results in multivariate linear regression analysis (P < 0.001). CONCLUSION: The risk of treatment failure is high in patients with severe pneumonia and with respiratory failure. Effective treatment and close monitoring are required for these cases.