원외폐렴으로 입원한 노인 환자에서 사망과 관련된 요인

Abstract

Background : Community-acquired pneumonia is one of the main causes of hospitalization and death, especially in elderly patients. There have been many studies on prognosis for community-acquired pneumonia, but few in Korea. We sought to identify characteristics on admission predicting mortality in elderly patients hospitalized with community-acquired pneumonia and to compare mortality rates by PORT score with PORT study's ones.

Methods : We performed a retrospective study of 267 patients aged 65 years and over admitted with community- acquired pneumonia from January 2000 to December 2002. We reviewed demographic, clinical, laboratory, microbiological and radiologic data and identified independent factors associated with the mortality using logistic regression analysis. We classified patients into risk classes by PORT score and calculated the mortality rate.

Results : Among of 267 patients, 48 (18.0%) died. We identified six independent predictors of mortality; male (OR, 2,496; 95% CI, 1,012∼6,153), lung cancer (OR, 3,409; 95% CI, 1,302∼8,920), general weakness (OR, 5.218; 95% CI, 2,140∼12,718), unable to walk (OR, 9,232; 95% CI, 2,228∼38,257), BUN ≥30 mg/dL (OR, 3,327; 95% CI, 1.072∼10.327), albumin ＜3 g/dL (OR, 3,219; 95% CI, 1,351∼7,670) and pleural effusion (OR, 3.135; 95% CI, 1,052∼9,342). Mortality rates of risk class II-V by PORT score were 6.7%, 9.5%, 30.4% and 34.4%, respectively.

Conclusion : There were factors that were associated with mortality in elderly patients hospitalized with community-acquired pneumonia.