Background: Community-acquired pneumonia (CAP) remains a major cause of death from infectious disease. Knowing its prognostic factors is important to tailor patient management. Previous studies overseas about predictors of mortality were mostly done on elderly. Only one previous study in Indonesia was found but it was limited on the elderly.
Objectives: To determine the mortality predictors in patients with CAP in Cipto Mangunkusumo Hospital, Jakarta. Methods: A retrospective cohort was conducted on hospitalized patients with CAP in Cipto Mangunkusumo Hospital between 2010-2014. Clinical data, laboratory results and outcome (all-causemortality and survival)were collected from medical records. Bivariate analysis using chi-Square test was performed on age group, loss of consciousness, comorbidity (represented as Charlson Comorbidity Index/CCI >5), sepsis, respiratory failure, severe pneumonia, hemoglobin level <9 g/dl, leucocyte count <4000/μl or >20000/μl, albumin level <3 g/dl and blood glucose level >200 mg/dl. Missing data were handled with multiple imputation. Multivariate logistic regression analysis was performed to identify independent predictors of mortality.
Results: A total of 434 patients were evaluated. In-hospital mortality rate was 23.9%. There were 237 (54.6%) female patients. Median age of population was 58 (18-89) years old and median length of stay was 8 (1-63) days. The most common pathogen was Klebsiella pneumoniae (28%). Multivariate analysis revealed severe pneumonia (OR 29.42; 95%CI 20.81-41.58), sepsis (OR 3.65; 95%CI 2.57-5.19), respiratory failure (OR 3.2; 95%CI 1.9-5.37), CCI score >5 (OR 2.25; 95%CI 1.6-3.15) and albumin level <3 g/dl (OR 1.42; 95%CI 1.04-1.95) as independent mortality predictors.
Conclusion: Severe pneumonia, respiratory failure, sepsis, CCI score >5 and albumin level <3 g/dl were independent predictors of in-hospital mortality among hospitalized patients with CAP in Cipto Mangunkusumo Hospital.
Key words: Community-acquired pneumonia, mortality predictors