Abstract
We aimed to investigate community-acquired pneumonia (CAP) requiring hospitalisation, empirically treated with b-lactam monotherapy, with 30-day mortality and risk factors predicting its complicated course. A prospective observational study was conducted at the Pulmonology and Allergology Department in a tertiary care university hospital. 253 consecutive patients diagnosed with CAP requiring hospitalisation were enrolled. Hospital admission was based on PSI or CRB-65 scores, severe comorbidities, signs of intoxication, aspiration risk, social risk consider-ations, ineffective prior antibiotic treatment. Fourty seven percent of the subjects had complications on admission, 13% developed new CAP complications during inpatient treatment. Overall, 53% of individuals had a complicated CAP course. 30-day mortality rate was 5.9%. The factors predicting a complicated CAP course were as follows: neuromuscular disease, multilobar opacities on chest X-ray (or computed tomography), and clinically unstable condition as evaluated using Halm's criteria. The mortality rate in CAP patients treated with b-lactam monotherapy is low. Neuromuscular disease, multilobar opacities, and clinically unstable condition as evaluated using Halm's criteria predict a complicated CAP course.
Highlights
We aimed to investigate community-acquired pneumonia (CAP) requiring hospitalisation, empirically treated with b-lactam monotherapy, with 30-day mortality and risk factors predicting its complicated course
The objective of the study is to investigate CAP treated with b-lactam monotherapy, 30-day mortality and risk factors predicting complicated CAP course
Multivariate logistic regression was performed with CAP complications as the dependent variable and the results reported as odds ratios (ORs) and 95% confidence intervals
Summary
We aimed to investigate community-acquired pneumonia (CAP) requiring hospitalisation, empirically treated with b-lactam monotherapy, with 30-day mortality and risk factors predicting its complicated course. The factors predicting a complicated CAP course were as follows: neuromuscular disease, multilobar opacities on chest X-ray (or computed tomography), and clinically unstable condition as evaluated using Halm’s criteria. Neuromuscular disease, multilobar opacities, and clinically unstable condition as evaluated using Halm’s criteria predict a complicated CAP course. Regardless of the progress in medical science, better health-care access, including specialised units, CAP prevention, pneumonia mortality still accounts for over 30% of all respiratory disease mortality rates [2]. In most cases of CAP, the patients recover completely, a part of them develop a complicated disease course which is linked to increased mortality from 11% to 24% [3]. There is an established link between complicated CAP course and an increased risk of prolonged hospitalisation, and 30-day mortality [5]
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