Am J Med Sci. 2023 May 21:S0002-9629(23)01201-6. doi: 10.1016/j.amjms.2023.05.008. Online ahead of print.
ABSTRACT
BACKGROUND: In patients with community-acquired pneumonia (CAP), the risk and protective factors influencing discharge outcomes have not been fully elucidated. Therefore, we aimed to investigate the factors affecting discharge outcomes and provide a theoretical basis for improving the cure rate of patients with CAP.
METHODS: We describe a retrospective epidemiological study of patients with CAP conducted from 2014 to 2021. We used age, sex, co-morbidities, multilobar involvement, severe pneumonia, the main abnormal symptoms present on admission, and pathogen-targeted therapy as variables that may affect discharge outcomes. These variables were included in subsequent logistic regression analyses. Discharge outcomes were divided into remission and cure.
RESULTS: Of a total of 1008 patients with CAP, 247 patients were discharged as remission. The results of multivariate logistic regression analyses showed that age >65 years, smoking history, co-morbidity of chronic obstructive pulmonary disease, co-morbidity of chronic heart disease, co-morbidity of diabetes, co-morbidity of malignancy, co-morbidity of cerebrovascular disease, pleural effusion, hypoxemia, respiratory failure, electrolyte disturbances, and severe pneumonia were independently associated with poor discharge outcomes (all P < 0.05), while pathogen-targeted therapy (odds ratio: 0.32, 95% confidence interval: 0.16-0.62) was found as a protective factor.
CONCLUSIONS: Age > 65 years, the presence of co-morbidities, the presence of admission symptoms such as electrolyte disturbances, and severe pneumonia are associated with a poor discharge outcome, while pathogen-targeted therapy is associated with a good discharge outcome. Patients with CAP with a defined pathogen are more likely to be cured. Our results suggest that accurate and efficient pathogen testing is essential for CAP inpatients.
PMID:37220846 | DOI:10.1016/j.amjms.2023.05.008