Clinical and Biochemical Parameters Correlation with Complications and Mortality in Community Acquired Pneumonia in A Tertiary Care Hospital OC26-OC30
Associate Professor, Department of General Medicine, D Block, Level 4, GMCH 32, Chandigarh, India.
Introduction: Pneumonia continues to remain a serious health risk despite ongoing efforts. Community Acquired Pneumonia (CAP) is a common respiratory disease often requiring hospitalisation and is a major cause of morbidity and mortality in the population.
Aim: To study clinical and biochemical profile of patient admitted with the diagnosis of community acquired pneumonia and to see the association with various complications and outcomes.
Materials and Methods: In this prospective study, 130 patients of CAP admitted in the institution were enrolled. Data relating to their age, gender, clinical profile, severity score, microbiological details, complications and outcome were recorded. All the laboratory parameters of the patients were compared among the survival and mortality groups using student’s t-test and Chi-square test. The analysis was performed using Statistical Packages for the Social Sciences (SPSS Inc, Chicago, IL, version 22.0 for windows). p-value <0.05 was significant.
Results: Out of 130 patients of CAP 109 (83.8%) survived and 21 (16.2%) died. Seventy were male (53.8%) and 60 female (46.1%). Increase mean pulse rate, respiratory rate, lactate and low blood pressure, low oxygen saturation, low GCS scale and acidosis were associated with increased mortality. Sputum cultures were positive in 33 (25.38%), common organism isolated was E. coli (8.5%), pseudomonas (6.9%) and methicillin sensitive staphylococcus (3.1%). The need for ICU admission, mechanical ventilation, inotropes were statistically significant and associated with high mortality (p<0.001). Mean quick Sequential Organ Failure Assessment (qSOFA) score and Systemic Inflammatory Response Syndrome (SIRS) score was higher in mortality group.
Conclusion: Early diagnosis, prompt severity scoring, early sepsis management and monitoring can reduce mortality in CAP. Underlying co-morbid conditions like diabetes, Chronic Obstructive Pulmonary Disease (COPD), hypertension and others need to be managed precisely to prevent adverse outcome.