The mortality causes and factors related to patients with pneumonia in Singburi Hospital

Abstract

Pneumonia is the most common leading cause of death in Singburi hospital, between 2015 to 2016. Therefore, this study aimed to investigate the association between the causes and the factor of death in pneumonia patients. This was the retrospective (case-control) study There were a total of 433 patients with a principal diagnosis of pneumonia at SIngburi Hospital, from January to December 2017. A 103 of patients who died from pneumonia were recruited in this study. The baseline characteristics and treatment courses were reviewed and collected from the medical record. The data in the study were shown in frequency, percentage, median, mean and standard deviation. A Multiple logistic regression analysis was performed to compute adjusted odds ratios (OR adj) and to find the correlation between influencing factors and the cause of death. For all analysis, a significant level of 0.050 was used and 95% confidence intervals were done.

Mean age of patients who died from pneumonia was 71.32 years old, which 58.30% were male, 96.10% had underlying disease, 31.10% admitted in ICU, 97.10% had comorbidity and complication, 26.2% had septicemia and the mean of hospital length of stay was 8.65 days. In Univariate analysis, it was found that the statistical significant relative factors with pneumonia patient’s mortality were underlying disease, blood pressure < 90/60 mmHg, pulse rate > 120 /min, respiratory rate ≥ 25 /min, white blood cell(WBC) count >20,000 cell/mm³, platelet count <100,000 cell/mm³, BUN ≥ 20 mg/dl, creatinine>1.40 mg/dl, albumin< 2.50 gm/dl, chest X- rays with alveolar infiltration pattern

and complicated findings (pleural effusion, atelectasis, pneumothorax or mass), hospital acquired pneumonia (HAP)/Ventilator associated pneumonia (VAP) and proper antibiotics.

In multiple logistic regression analysis, it was found that statisticaly significant relative factors with pneumonia patient’s mortality (Odds ratio; 95% confidence interval; p-value <0.050) were body temperature < 36 °C (OR 13.742 ; 95% CI 1.508-125.276; p 0.020), GCS < 8 (OR 10.991 ; 95% CI 1.730-69.833; p 0.011), bacteriemia (OR 7.012 ; 95% CI 1.679-29.292; p 0.008)  and proper antibiotics use (OR 0.009 ;95% CI 0.001-0.068; p<0.001).

In conclusion, the significant causes and factors that associate with pneumonia patient’s mortality were patient’s body temperature less than 36 °C, alteration of consciousness (GCS<8) and bacteriemia. The important factor which decreased pneumonia patient’s mortality is proper antibiotic use.