Ghazal Shaista, Kumar Ashok, Shrestha Binav, Sajid Sana, Malik Maria, Rizvi Nadeen
Department of Chest Medicine, Jinnah Postgraduate Medical Center, Karachi, Pakistan.
Bolan Medical College, Quetta, Pakistan.
JNMA J Nepal Med Assoc. 2013 Oct-Dec;52(192):571-5.
Lung abscess is a commonly encountered entity in South-East Asia but not much data regarding its outcome is available. The objective of this study was to identify the factors associated with increased mortality in patients diagnosed with lung abscess in a tertiary care center of Karachi, Pakistan.
A retrospective case analysis was performed via hospital records, on patients admitted with lung abscess between January 2009 and January 2011 at the largest state-owned tertiary care centre in Karachi, Pakistan. Out of the 41 patients hospitalized, 17 could not survive and were evaluated for clinical, radiological and microbiological factors to determine association with heightened mortality.
Mortality due to lung abscess stood at 41.4% (17 of 41 cases). Adult male patients were found to have higher mortality with 13 out of 17 (43%) dead patients being male. A majority (21/41, 51.2%) of the cases belonged to the 41-60 year old age group. Highest mortality was seen in patients<20 years of age (3/4, 75%). Patients with blood sugar levels of >200 mg/dL (56%) succumb to disease. Patients with a positive history of smoking, diabetes mellitus, and alcohol intake expressed mortality rates of 44%, 56%, and 50% respectively; while 29.4% of the mortalities were positive for Pseudomonas aeruginosa on sputum culture. A significant association was found with elevated mortality and low haemoglobin levels at time of admission; mortality was 58% (p=0.005) in patients with Hb less than or equal to 10 mg/dL.
The risk factors involved with heightened mortality included male gender and history of smoking, diabetes and alcohol intake. High blood sugar levels and detection of Pseudomonas aeruginosa on sputum cultures were also implicated. Anemia (Hb level less than or equal to 10 mg/dl) was statistically significant predictive factor for increased mortality.
肺脓肿在东南亚是一种常见病症，但关于其转归的数据并不多。本研究的目的是确定在巴基斯坦卡拉奇一家三级医疗中心被诊断为肺脓肿的患者中，与死亡率增加相关的因素。
通过医院记录对2009年1月至2011年1月期间在巴基斯坦卡拉奇最大的国有三级医疗中心因肺脓肿入院的患者进行回顾性病例分析。在41例住院患者中，17例未能存活，并对其临床、放射学和微生物学因素进行评估，以确定与死亡率升高的关联。
肺脓肿导致的死亡率为41.4%（41例中的17例）。发现成年男性患者死亡率较高，17例死亡患者中有13例（43%）为男性。大多数病例（41例中的21例，51.2%）属于41至60岁年龄组。<20岁的患者死亡率最高（4例中的3例，75%）。血糖水平>200mg/dL的患者（56%）死于该病。有吸烟、糖尿病和饮酒史的患者死亡率分别为44%、56%和50%；而29.4%的死亡患者痰培养铜绿假单胞菌呈阳性。发现入院时死亡率升高与血红蛋白水平低之间存在显著关联；血红蛋白小于或等于10mg/dL的患者死亡率为58%（p=0.005）。
死亡率升高涉及的危险因素包括男性性别以及吸烟、糖尿病和饮酒史。高血糖水平和痰培养检测到铜绿假单胞菌也与之有关。贫血（血红蛋白水平小于或等于10mg/dl）是死亡率增加的统计学显著预测因素。
