Abstract

Objective: Nowadays, both community- and hospital-acquired pneumonias (HAP) are significant causes of mortality and morbidity. In our study, we aimed to analyze hospitalized pneumonia patients using the pneumonia severity index (PSI) and investigate the effect of pneumonia type and severity on follow-up and treatment.

Methods: The records of 83 patients hospitalized due to pneumonia were retrospectively evaluated. The PSI was used to determine disease severity. And, p<0.05 was regarded as the statistically significant value.

Results: The mean age of patients was 70.8±15.4 years and 50 (60.2%) were male. Bilateral involvement was seen in 23 (27.7%) and pleural fluid in 19 (22.9%) patients on chest x-ray. While 67 (80.7%) patients had community-acquired pneumonia (CAP), 16 (19.3%) patients had HAP. Microbiological diagnosis was obtained in 9 (56.2%) HAP and 6 (8.9%) CAP cases. Response to empirical treatment was 77.6% in CAP patients and 31.2% in HAP patients (p=0.000). Modification frequency in empirical antibiotic therapy was significantly higher in patients with higher PSI (p=0.001). Mortality rate was 5.9% in CAP cases, whereas it was 43.7% in HAP cases (p=0.000). PSIs were significantly higher in the patients that died (p=0.025). A positive correlation was detected between PSI and duration of hospital stay (p=0.000), duration of intensive care unit stay (p=0.046), and duration of therapy (p=0.002).

Conclusions: The response to initial antimicrobial therapy was lower and need for intensive care and mortality rate were higher in patients with HAP compared to patients with CAP. The PSIs in hospitalized pneumonia patients are related to the success of empirical antibiotic therapy, duration of hospital stay, duration of therapy and mortality.