CLINICAL AND BLOOD PARAMETERS IN RELATION TO THE OUTCOMES OF COMMUNITY ACQUIRED PNEUMONIA

Abstract

Background: Risk stratification of Community acquired pneumonia (CAP) is challenging for physicians. Though various biomarkers are available, they are costly or not readily available in all health care settings. This study aimed to analyze the prognostic value of routinely available clinical and blood parameters in relation to the outcome of patients admitted with community acquired pneumonia.

Methods: This was a hospital-based observational study of the patients admitted to Chitwan Medical College (CMC), Nepal between August 2021 and December 2021. We enrolled patients 18 years old and above with the diagnosis of CAP in the study and excluded patients with COVID and active pulmonary tuberculosis. The outcomes of the patients were recorded as improved, not-improved, or dead. Fischer exact, Kruskal-Wallis or Mann-Whitney tests were used for analysis wherever appropriate.

Results: Total 92 patients with mean age 58.2 years were enrolled in the study. Patients who were not improved or were dead had higher age (p=0.029), respiratory rate (p<0.001), shock index (p=0.013), total leukocyte count (TLC) (p=0.019), urea (p=0.046), creatinine (p<0.01), potassium (p<0.001), bilirubin (p=0.029), and lactate (P<0.05) and lower SpO2 (p<0.01), SpO2/FiO2 (p=0.018), pH (p=0.0497), and PaCO2 (p<0.001). Patients with nervous (p<0.001), cardiovascular (p=0.032) and renal system (p=0.019) involvement were also found to be associated with poor outcome.

Conclusions: CAP patients with higher TLC, urea, creatinine, bilirubin and lactate, with lower SpO2, SpO2/FiO2, pH and PaCO2 and with involvement of more than one organ systems were found to have unfavorable prognosis. Higher potassium level was also found to be a potential marker of CAP severity.