A Retrospective Analysis of Mortality Due to Pneumonia and Renal Disease in a Midwestern Patient Population.

BACKGROUND

The impact of pneumonia (PNA) with concomitant renal disease (RD) has not been fully investigated in a United States Midwestern patient population, despite the morbidity and mortality associated with such diseases.

MATERIALS AND METHODS

A retrospective cohort study was performed on International Classification of Diseases, 10 Revision (ICD-10) data from a hospital system located in Southwest Missouri. Data was acquired from patients admitted between January 2019 and December 2021. Patients were separated into five groups (disease categories): acute kidney injury (AKI), chronic kidney disease (CKD), PNA, AKI with PNA, and CKD with PNA. The data were analyzed, and subset analysis was performed utilizing two-sample proportion tests (Wald test) to compare mortality rates. Informed consent was not needed due to the retrospective nature of the study.

RESULTS

The mortality rate of patients with PNA with AKI and PNA with CKD was 36.08% (32.87% to 39.28%, 95% CI) and 24.97% (21.93% to 28.00%, 95% CI), respectively, revealing a significant increase in mortality for thosediagnosed with PNA and AKI -higher than any other disease category. For reference, PNA without (w/o) RD, CKD w/o PNA, and AKI w/o PNA had much lower mortality rates at 9.45%, 7.87% and 12.19%, respectively, with AKI w/o PNA having a 2.63% to 6.00% higher (p<0.0001) and 0.99% to 4.49% higher (p=0.0020), mortality alone than CKD w/o PNA or PNA w/o RD, respectively.

DISCUSSION AND CONCLUSION

Mortality associated with RD and PNA was examined in a predominantly rural, relatively poor, Midwestern patient population presenting to a tertiary center with the key finding that the presence of AKI correlates with a much greater mortality rate in both patients with and without PNA. Looking forward, future studies may include a broader population base(including urban, suburban, and rural areas), allowing not only for more statistical power but also a broader assessment of the population.Such knowledge is invaluable as we continue to prioritize healthcare resources for critically ill patients suffering from RD and PNA in different settings.