Jahanihashemi Hassan, Babaie Mona, Bijani Soroush, Bazzazan Maryam, Bijani Behzad
Department of Community Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.
Clinical Microbiology Research Centre, Qazvin University of Medical Sciences, Qazvin, Iran.
Int J Clin Pract. 2018 May;72(5):e13085. doi: 10.1111/ijcp.13085. Epub 2018 Apr 17.
Community-acquired pneumonia (CAP) is one of the most severe lower respiratory tract infections with a high in-hospital mortality. The aim of this study was to investigate the socioeconomic and medical risk factors affecting the prognosis of acute pneumonia. The results of this study can mention the value of socioeconomic backgrounds like poverty and illiteracy in clinical practice, even in a well-known biological phenomenon (eg acute pneumonia).
In this cross-sectional study, all admitted patients to a tertiary teaching hospital with a diagnosis of community acquired pneumonia in a 12-month period were enrolled. Socioeconomic and demographic characteristics, underlying conditions, clinical manifestations and para-clinical test results at admission registered prospectively. A logistic regression model was conducted using in-hospital mortality as the dependent variable.
A total of 621 patients was included in this study. Among them, 47 patients (7.6%) died during the hospitalisation period. In multiple logistic regression analysis, pleural effusion, a higher CURB-65 score, hyponatremia, hyperglycaemia and poverty (being in the lower economic class) were identified as independent risk factors for in-hospital mortality in community-acquired pneumonia.
Numerous factors can influence the prognosis of CAP. In addition to the CURB-65 score and some other medical risk factors, socioeconomic backgrounds can also affect the early outcome in CAP. In this study, being in the lower economic class (as an indicator of poverty) is interpreted as an independent risk factor for a poor prognosis in CAP.
社区获得性肺炎（CAP）是最严重的下呼吸道感染之一，院内死亡率很高。本研究的目的是调查影响急性肺炎预后的社会经济和医学风险因素。本研究结果可以揭示社会经济背景（如贫困和文盲）在临床实践中的价值，即使是在一个众所周知的生物学现象（如急性肺炎）中。
在这项横断面研究中，纳入了一家三级教学医院在12个月期间收治的所有诊断为社区获得性肺炎的患者。前瞻性记录入院时的社会经济和人口统计学特征、基础疾病、临床表现和辅助检查结果。以院内死亡率为因变量进行逻辑回归模型分析。
本研究共纳入621例患者。其中，47例（7.6%）在住院期间死亡。在多因素逻辑回归分析中，胸腔积液、较高的CURB-65评分、低钠血症、高血糖和贫困（处于较低经济阶层）被确定为社区获得性肺炎院内死亡的独立危险因素。
许多因素可影响CAP的预后。除了CURB-65评分和其他一些医学风险因素外，社会经济背景也会影响CAP的早期结局。在本研究中，处于较低经济阶层（作为贫困的一个指标）被解释为CAP预后不良的独立危险因素。
