Mortality predictors in community-acquired pneumonia

To determine mortality predictors among patients admitted for community-acquired pneumonia to the medical wards of Ladoke Akintola University of Teaching Hospital between Jan. 2003 and Dec. 2005.

The case notes of 65 patients admitted for community-acquired pneumonia were studied with respect to their admission Pneumonia Severity Index (PSI) (Score) and functional class. The duration of admission, side of lung affected on chest X-ray, co-morbid illness and outcome were also noted.

The mean Pneumonia Severity Index score for patients who were discharged and those who died was 65.48 +/- 32.6 and 95.47 +/- 32.9 respectively (P<0.05). Bedridden patients have higher mortality than patients who walked without problems on admission (P<0.05). The mean duration of admission of discharged patients was 9.5 +/- 8.9 days while that of patients who died was 4.82 +/- 2.7 days (P<0.05). The side of lung involvement of chest X-ray does not seem to affect mortality (P>0.05). Sixteen co-morbid illnesses were identified.

The Pneumonia Severity Index score remains an important mortality predictor in patients with community-acquired pneumonia, but there is need to widen its scope to include functional class, duration of admission, and locally important co-morbid illnesses.