F Tokgoz Akyil1, M Yalcinsoy2, A Hazar3, A Cilli4, B Celenk4, O Kilic5, A Sayiner6, N Kokturk7, A Sakar Coskun8, A Filiz9, E Cakir Edis10. 1. Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Chest Diseases, İstanbul, Turkey. Electronic address: fatmatokgoz86@gmail.com. 2. Inonu University, Faculty of Medicine, Department of Chest Diseases, Battalgazi/Malatya, Turkey. 3. Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Chest Diseases, İstanbul, Turkey. 4. Akdeniz University, Faculty of Medicine, Department of Chest Diseases, Konyaaltı/Antalya, Turkey. 5. Dokuz Eylul University, Faculty of Medicine, Department of Chest Diseases, Konak/İzmir, Turkey. 6. Ege University, Faculty of Medicine, Department of Chest Diseases, Bornova/İzmir, Turkey. 7. Gazi University, Faculty of Medicine, Department of Chest Diseases, Yenimahalle/Ankara, Turkey. 8. Celal Bayar University, Faculty of Medicine, Department of Chest Diseases, Yunusemre - Manisa, Turkey. 9. Gaziantep University, Faculty of Medicine, Department of Chest Diseases, Şehitkamil/Gaziantep, Turkey. 10. Trakya University, Faculty of Medicine, Department of Chest Diseases, İskender Köyü/Edirne Merkez/Edirne, Turkey.
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.
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 ureanitrogen (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.
Authors: Lee Hooper; Asmaa Abdelhamid; Sarah M Ajabnoor; Chizoba Esio-Bassey; Julii Brainard; Tracey J Brown; Diane Bunn; Eve Foster; Charlotte C Hammer; Sarah Hanson; Florence O Jimoh; Hassan Maimouni; Manraj Sandhu; Xia Wang; Lauren Winstanley; Jane L Cross; Ailsa A Welch; Karen Rees; Carl Philpott Journal: Clin Nutr ESPEN Date: 2021-11-19