КЛИНИЧЕСКИЕ ОСОБЕННОСТИ ПНЕВМОНИЙ С НЕБЛАГОПРИЯТНЫМ ИСХОДОМ

Abstract

We studied clinical characteristics of pneumonia associated with therapeutic failure. The research was based on the materials of the therapeutic department of the Angapov Republican Clinical Emergency Hospital of Ulan-Ude for the period of 2013-2015. 7449 patients were treated in the department for three years, 462 of them died (6.3 %). 154 cases of deaths from pneumonia were registered during that period. Patients who died of pneumonia were primary men - 53.2 %, older than 40 years - 85.8 %, had bilateral lung damage - 58.4 % and severe comorbidities. Only 27.2 % of them had a primary diagnosis of pneumonia. In other cases, pneumonia was a concomitant disease and occurred in patients with chronic alcohol intoxication in more than half of these cases. A direct correlation has been established between the number of deaths and the age of patients in the group of people with a primary diagnosis of pneumonia; bilateral lung damage was observed in 54.1 % of patients in this group. In another group, where pneumonia was a complication of the underlying disease, the highest mortality was observed in the age group 40-59 years (43.8 % of cases) - among working-age people. 17.6 % of patients who died were younger than 40 years; they were injection drug users and had HIV. 59.9 % of patients in this group had a bilateral lung damage. At the moment of admission patients had a primary diagnosis of toxic action of ethanol - in 42.0 %, chronic obstructive pulmonary disease - in 18 %, liver cirrhosis - in 7 %, acute poisoning - in 10.7 % of cases.