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- Title
Predictors of in-hospital mortality and length of stay in community-acquired pneumonia: a 5-year multi-centre case control study of adults in a developing country.
- Authors
Iroezindu, Michael O.; Isiguzo, Godsent C.; Chima, Emmanuel I.; Mbata, Godwin C.; Onyedibe, Kenneth I.; Onyedum, Cajetan C.; John-Maduagwu, Obiageli J.; Okoli, Leo E.; Young, Ekenechukwu E.
- Abstract
Background: We investigated predictors of in-hospital mortality and length of hospital stay among adults with community-acquired pneumonia (CAP) in Nigeria in order to provide recommendations to improve CAP outcomes in developing countries. Methods: This was a multi-centre case control study of patients ≥18 years who were admitted with CAP between 2008 and 2012. Case notes of 100 consecutive patients who died (cases) and random sample of 300 patients discharged (controls) were selected. Results: Mean ages were 55.4±19.6 (cases) and 49.3±19.2 (controls). Independent predictors of mortality were CURB-65 score ≥3: adjusted odds ratio (aOR) 24.3, late presentation: aOR 8.6, co-morbidity: aOR 3.9, delayed first dose antibiotics (>4 hours): aOR 3.5, need for supplemental oxygen: aOR 4.9, multilobar pneumonia: aOR 4.0, non-pneumococcal aetiology: aOR 6.5, anaemia: aOR 3.8 and hyperglycemia: aOR 8.6. CURB-65 ≥3 predicted mortality with a high specificity (96.1%) but low sensitivity (75%); positive predictive value of 88.2% and negative predictive value of 90.8%. Care in hospital A and B: aOR 3.3 and 2.2 respectively, male gender aOR 2.1, co-morbidity aOR 3.0, anaemia aOR 2.1 and elevated serum creatinine aOR 6.3 independently predicted length of hospital stay >10 days among survivors. Conclusions: Several modifiable patient-related and process-of-care factors predicted in-hospital mortality, and length of hospital stay among survivors. Our findings should be used to improve CAP outcomes in developing countries.
- Subjects
MORTALITY; COMMUNITY-acquired pneumonia; COMMUNITY-acquired infections; LENGTH of stay in hospitals; PUBLIC health in developing countries
- Publication
Transactions of the Royal Society of Tropical Medicine & Hygiene, 2016, Vol 110, Issue 8, p445
- ISSN
0035-9203
- Publication type
Article
- DOI
10.1093/trstmh/trw057