FACTORS EFFECTING THE DURATION OF HOSPITALIZATION AND MORTALITY IN PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA

Community-acquired pneumonia (CAP) is a common infectious disease with high morbidity and mortality. In this study, demographic features, underlying conditions, causative pathogens and factors affecting length of hospital stay and mortality were retrospectively investigated in patients who were diagnosed as CAP and followed-up in our unit between January 2005-December 2007. Among 97 patients 65 (67%) were male, 32 (33%) were female and the mean age was 62.7 (age range: 18-94) years. Patients were grouped according to criteria of Turkish Thoracic Society into four groups; 22 were group 2 (patients with risk factors, without aggrevating factors), 59 were group 3 (patients with aggrevating factors), and 16 were group 4 (patients who have necessity for intensive care) CAP. The patients have also been grouped according to criteria of American Thoracic Society (CURB-65 score = Confusion, Urea > 7 mmol/L, Respiratory rate >= 30/min, low Blood pressure and being >= 65 years old), as group I (n = 65), group II (n = 20), and group III (n = 12). During follow-up 11 (11.3%) patients required mechanical ventilation support and 6 (6.2%) patients have died. Causative pathogens were isolated from 14 (23.3%) out of 27 well-qualified sputum samples obtained from 60 patients who could produce sputum (8 Streptococcus pneumoniae, 2 methicillin-sensitive Staphylococcus aureus, 2 Klebsiella pneumoniae, 1 Haemophilus influenzae, I Moraxella catarrhalis). Thirty-seven of cases were treated with levofloxacin, 10 with moxifloxacin, 24 with ceftriaxone +/- clarithromycin, 16 with sulbactam-ampicillin +/- ciprofloxacin, 10 with beta-lactam/beta-lactamase inhibitor combinations, and fever declined within 2.5 days in 83 (85.6%) of them. The mean duration of hospital stay was estimated as 11.1 days. In the evaluation of the factors that affect the length of hospital stay, being >= 65 years old, gender, underlying conditions, central venous catheterisation, presence of nasogastric tube, positive culture result, previous antibiotic treatment, fever continuing for > 3 days despite antibiotic therapy and scoring groups were not determined as risk factors (p > 0.05 for all of these parameters). However, mechanical ventilation was found as a significant risk factor (p < 0.05). In the evaluation of the factors that affect mortality, mechanical ventilation (p < 0.001), staying in intensive care unit (p < 0.001), being group 4 CAP (p < 0.001) and fever continuing for > 3 days despite antibiotic therapy (p = 0.05) were found to be significant risk factors. In conclusion, length of hospital stay, mortality and treatment costs in CAP patients could be reduced by defining the risk factors and starting empirical antibiotic therapy according to the national and international guidelines.

Yazar Piskin, Nihal
Aydemir, Hande
Oztoprak, Nefise
Akduman, Deniz
Celebi, Gueven
Keskin, Ayseguel Seremet
Yayın Türü Article
Tek Biçim Adres https://hdl.handle.net/20.500.12628/2638
Konu Başlıkları Community-acquired pneumonia
length of hospital stay
mortality
risk factors
Koleksiyonlar Araştırma Çıktıları | WoS | Scopus | TR-Dizin | PubMed | SOBİAD
PubMed İndeksli Yayınlar Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu
Dergi Adı MIKROBIYOLOJI BULTENI
Dergi Cilt Bilgisi 43
Dergi Sayısı 4
Sayfalar 597 - 606
Yayın Yılı 2009
Eser Adı
[dc.title]
FACTORS EFFECTING THE DURATION OF HOSPITALIZATION AND MORTALITY IN PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA
Yazar
[dc.contributor.author]
Piskin, Nihal
Yazar
[dc.contributor.author]
Aydemir, Hande
Yazar
[dc.contributor.author]
Oztoprak, Nefise
Yazar
[dc.contributor.author]
Akduman, Deniz
Yazar
[dc.contributor.author]
Celebi, Gueven
Yazar
[dc.contributor.author]
Keskin, Ayseguel Seremet
Yayın Yılı
[dc.date.issued]
2009
Yayıncı
[dc.publisher]
ANKARA MICROBIOLOGY SOC
Yayın Türü
[dc.type]
article
Özet
[dc.description.abstract]
Community-acquired pneumonia (CAP) is a common infectious disease with high morbidity and mortality. In this study, demographic features, underlying conditions, causative pathogens and factors affecting length of hospital stay and mortality were retrospectively investigated in patients who were diagnosed as CAP and followed-up in our unit between January 2005-December 2007. Among 97 patients 65 (67%) were male, 32 (33%) were female and the mean age was 62.7 (age range: 18-94) years. Patients were grouped according to criteria of Turkish Thoracic Society into four groups; 22 were group 2 (patients with risk factors, without aggrevating factors), 59 were group 3 (patients with aggrevating factors), and 16 were group 4 (patients who have necessity for intensive care) CAP. The patients have also been grouped according to criteria of American Thoracic Society (CURB-65 score = Confusion, Urea > 7 mmol/L, Respiratory rate >= 30/min, low Blood pressure and being >= 65 years old), as group I (n = 65), group II (n = 20), and group III (n = 12). During follow-up 11 (11.3%) patients required mechanical ventilation support and 6 (6.2%) patients have died. Causative pathogens were isolated from 14 (23.3%) out of 27 well-qualified sputum samples obtained from 60 patients who could produce sputum (8 Streptococcus pneumoniae, 2 methicillin-sensitive Staphylococcus aureus, 2 Klebsiella pneumoniae, 1 Haemophilus influenzae, I Moraxella catarrhalis). Thirty-seven of cases were treated with levofloxacin, 10 with moxifloxacin, 24 with ceftriaxone +/- clarithromycin, 16 with sulbactam-ampicillin +/- ciprofloxacin, 10 with beta-lactam/beta-lactamase inhibitor combinations, and fever declined within 2.5 days in 83 (85.6%) of them. The mean duration of hospital stay was estimated as 11.1 days. In the evaluation of the factors that affect the length of hospital stay, being >= 65 years old, gender, underlying conditions, central venous catheterisation, presence of nasogastric tube, positive culture result, previous antibiotic treatment, fever continuing for > 3 days despite antibiotic therapy and scoring groups were not determined as risk factors (p > 0.05 for all of these parameters). However, mechanical ventilation was found as a significant risk factor (p < 0.05). In the evaluation of the factors that affect mortality, mechanical ventilation (p < 0.001), staying in intensive care unit (p < 0.001), being group 4 CAP (p < 0.001) and fever continuing for > 3 days despite antibiotic therapy (p = 0.05) were found to be significant risk factors. In conclusion, length of hospital stay, mortality and treatment costs in CAP patients could be reduced by defining the risk factors and starting empirical antibiotic therapy according to the national and international guidelines.
Açıklama
[dc.description]
WOS: 000271840400009
Açıklama
[dc.description]
PubMed: 20084912
Kayıt Giriş Tarihi
[dc.date.accessioned]
2019-12-23
Açık Erişim Tarihi
[dc.date.available]
2019-12-23
Yayın Dili
[dc.language.iso]
tur
Konu Başlıkları
[dc.subject]
Community-acquired pneumonia
Konu Başlıkları
[dc.subject]
length of hospital stay
Konu Başlıkları
[dc.subject]
mortality
Konu Başlıkları
[dc.subject]
risk factors
Haklar
[dc.rights]
info:eu-repo/semantics/closedAccess
ISSN
[dc.identifier.issn]
0374-9096
İlk Sayfa Sayısı
[dc.identifier.startpage]
597
Son Sayfa Sayısı
[dc.identifier.endpage]
606
Dergi Adı
[dc.relation.journal]
MIKROBIYOLOJI BULTENI
Dergi Sayısı
[dc.identifier.issue]
4
Dergi Cilt Bilgisi
[dc.identifier.volume]
43
Tek Biçim Adres
[dc.identifier.uri]
https://hdl.handle.net/20.500.12628/2638
Görüntülenme Sayısı ( Şehir )
Görüntülenme Sayısı ( Ülke )
Görüntülenme Sayısı ( Zaman Dağılımı )
Görüntülenme
29
09.12.2022 tarihinden bu yana
İndirme
1
09.12.2022 tarihinden bu yana
Son Erişim Tarihi
09 Şubat 2024 07:11
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factors patients antibiotic mortality hospital ventilation therapy (patients according mechanical length sputum Thoracic Society aggrevating factors) criteria intensive affect evaluation pneumoniae underlying continuing significant conditions despite groups treatment grouped pathogens declined Staphylococcus within levofloxacin moxifloxacin
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