Analysis of the lethal outcomes in patients with severe pneumonia
1Internal Diseases, Kazan State Medical University, Kazan, Russian Federation
Some factors besides treatment can significantly influence on the fatal outcomes of pneumonia. Objective. Identification of non-medication risk factors of death based on study of the inpatients clinical signs of pneumonia. Methods. Retrospective analyze of 62 case histories of patients died from pneumonia in hospitals: 12 women and 50 men of 30 to 88 years. Results. 24% of patients had constant job, 76% were not working. 21% of patients had a disability for chronic diseases. The beginning of disease averaged 5,4 days before hospitalization. The recourse was on average 1 day before hospitalization. The most frequent complaints were cough (10% with hemoptysis), weakness and dyspnea. 45% of patients smoked. 50% abused alcohol. Dipsomania preceded hospitalization in 40% of cases. 10% had a drug addiction, 5% were HIV-positive, 13% had chronic viral hepatitis B and C. Leading role of cardiovascular (66%) and gastrointestinal (65%) pathology have been revealed.
Based on dates of autopsies, attention should be paid to alcoholic genesis of these diseases. Coronary heart disease and hypertension took place much rarer. In 40% we observed various stages of consciousness disturbance from mild lethargy to coma. In 69% we saw skin and mucosa cyanosis, in 63% - tachypnea, 55% - hypotension. 57% had body mass deviations. In 63% we observed bilateral pneumonia, in 33% - pleural effusion. Conclusions. Social status, late hospitalization, smoking, alcoholism, alcoholic genesis of comorbidity, deviation of the mental, nutritive status, bilateral pneumonia, pleural effusion, hemodynamic disorders should be recognized as non-medication predictors of fatal outcome, requiring early attention and subsequent correction of treatment.