Risk factors for fatal outcome in patients with community-acquired pneumonia
R.I. Shaymuratov, A.A. Vizel
Department of Phthisiopulmonology, Kazan State Medical University, Kazan, Russia
Background. Community-acquired pneumonia (CAP) is the leading cause of death from infectious diseases. Despite the achievements in the organization and tactics of treating pneumonia, questions concerning identification of the most significant and modifiable risk factors for the development of fatal outcomes remain.
Objective. Identification of risk factors for the unfavorable CAP outcome and their relationship with the criteria for the quality of medical care.
Methods. A retrospective observational study of the medical records of deceased and recovered CAP patients using the method of group balancing (copy-pair) was carried out.
Results. A total of 160 deaths and 160 favorable outcomes were analyzed in patients over 18 years of age who were admitted for treatment to the hospitals of the Republic of Tatarstan. The copy-pair method showed that precise correlation of pairs leads to the mutual leveling of selection criteria and the appearance of new regularities. Factor analysis identified variables that are leading in predicting the course of the disease.
Conclusion. Patients with fatal CAP outcomes demonstrate more pronounced abnormalities in physical data, laboratory analyzes, results of special exams, and positive dynamics, on the contrary, is weaker than in those recovered. Criteria for the quality of medical care along with risk factors contribute to the CAP prognosis; it should be borne in mind that management of quality criteria is simpler than management of risk factors. Failure to follow recommendations for providing medical care to CAP patients can lead to death, even if patients do not have risk factors for fatal outcome.
About the Autors
Corresponding author: Alexander A. Vizel, MD, Prof., Head of the Department of Phthisiopulmonology, Kazan State Medical University, Chief Specialist-Pulmonologist of the Ministry of Health of the Republic of Tatarstan (RT), Honored Doctor of RT, Laureate of the State Prize of the Republic of Tatarstan in the field of Science and Technology, Kazan, Russia; e-mail: email@example.com, ORCID: https://orcid.org/0000-0001-5028-5276; Address: 49, Butlerov Street, Kazan 420012, Russian Federation