Burden of community acquired pneumonia in medically admitted patients with positive past admission history
Department of Internal Medicine, King Hussein Medical Center, Royal Medical Services, Jordan.
Research Article
World Journal of Biology Pharmacy and Health Sciences, 2024, 20(02), 433–441.
Article DOI: 10.30574/wjbphs.2024.20.2.0865
Publication history:
Received on 04 November 2024; revised on 16 November 2024; accepted on 18 November 2024,
Abstract:
Aims: The study examined the correlation between Community-Acquired Pneumonia (CAP) burden in hospitalized geriatric patients and their history of admission frequency, revealing a correlation between previous admissions and CAP burden in newly admitted patients.
Methods: This study analyzed geriatric patients aged 65 and above admitted to King Hussein Medical Centre in Amman, Jordan. The patients were divided into two age groups and assessed for prognostic factors such as frequency of prior admissions, CURB-65 assessment score, comorbidity burden, and composite outcomes of interest (cOI). The study found that positive cOI was associated with adverse outcomes such as high admission rates, transfers to critical care units, oxygen desaturation, and mortality. Patients were divided into two groups based on Community-Acquired Pneumonia (CAP) diagnosis, with improved cOI indicating the absence of adverse outcomes. The study conducted multiple linear regression analysis to investigate the relationship between past admission frequencies and CAP severity. The results showed significant correlations between factors such as age, gender, and comorbidity burden.
Results: This retrospective observational study evaluated 641 geriatric patients who were medically admitted for community-acquired pneumonia (CAP). The results showed that approximately 52.73% (338 patients) experienced a negative diagnosis of CAP, while 47.27% (303 patients) experienced a positive diagnosis. The study found a statistically significant difference in the tested gender between the dichotomised outcome groups (Groups I-II). The odds ratio for a positive CAP in elderly geriatric patients admitted for medical reasons was found to be 3.441. The CAP positivity group had a distribution rate for poorer outcomes of approximately 74.9% (227 patients) compared to 29.0% (98 patients) in the CAP negativity group. The study also found a statistically significant association between comorbidity burden and frailty among geriatric patients. The highest distribution rates were observed in geriatric patients with a CURB-65 score of 3, followed by those with a score of 4, with frequencies of 171 (56.4%) and 124 (40.9%), respectively. The study performed a multiple linear regression analysis, focusing on the assessment of CURB-65 scores in geriatric patients diagnosed with community-acquired pneumonia who were medically admitted. The constructed regression model accounted for approximately 86.4% of the variability in the target variable, as explained by the four independent variables tested.
Conclusion: The study found a significant correlation between geriatric patients' prior admission history and the diagnosis of community-acquired pneumonia, indicating an increased severity of CAP with a higher frequency of past admission days.
Keywords:
Community acquired pneumonia; Medically admitted patients; Positive admission days
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