Abstract
ABSTRACT
 Introduction: Community acquired pneumonia is one of the leading causes of morbidity and mortality globally with the highest burden being reported from Asia. In Bhutan, community acquired pneumonia was reported to be one of the top five causes of mortality and one of the top ten causes of morbidity.
 Methods: This was an observational study done in a cohort of adult patients with community acquired pneumonia who were admitted to National Referral Hospital of Bhutan from February 2020 – February 2021 using purposive sampling. The Research Ethics Board of Health, Bhutan, gave ethical approval. We evaluated the burden and outcome of the community acquired pneumonia, and assessed the predictive capability of CURB-65 score to predict mortality as an outcome in these patients.
 Results: The inpatient burden of community acquired pneumonia was found to be 4.7% among patients admitted to medical wards. The mortality was 7.8%. 15.7 % of patients were managed in the intensive care unit out of which 5.9% patients needed mechanical ventilation. The mean hospital length of stay of these patients was 13 days. The sensitivity, specificity, PPV and NPV of CURB-65 score to predict death as an outcome in these patients were 87.5%, 43.6%, 11.7% and 97.6% respectively.
 Conclusion: The inpatient burden of Community Acquired Pneumonia in the National Referral Hospital is of concern. The CURB-65 score can be used a supplement to clinical judgement to assess the severity of the disease and make appropriate management decisions.
Highlights
Community-acquired pneumonia (CAP) is one of the leading causes of morbidity and mortality globally with the highest burden being reported from Asia
We studied the burden of CAP in adult patients admitted in the National Referral Hospital and described the outcome in terms of discharge, intensive care unit admissions and mechanical ventilation, length of hospital stay and death
There were a total of 2155 patients admitted in the medical wards of the national referral hospital during the study period
Summary
Community-acquired pneumonia (CAP) is one of the leading causes of morbidity and mortality globally with the highest burden being reported from Asia. The burden and outcome of the CAP was evaluated and the predictive capability of CURB-65 (Confusion, urea, respiratory rate, blood pressure and age ≥ 65) score to predict mortality as an outcome in these patients was assessed. The CURB-65 score can be used as a supplement to the clinical judgement to assess the severity of the disease and make appropriate management decisions. Assessing the severity of the illness and making the appropriate management decisions can minimize unnecessary hospital admission and exhaustion of resources, November | Vol 7 | Issue 2 and prioritize patients requiring prompt intensive unit care and thereby reduce the likelihood of complications and death. Using the CURB-65 score, patients can be classified into low, intermediate and high-risk groups[5,6]
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