Clinical Outcomes of Community-Acquired Pneumonia in Young Adults: Analysis Using the Pneumonia Severity Index (PSI)

以肺炎嚴重程度指數(PSI)分析年輕人社區性肺炎的臨床結果

黃軒(Hean Ooi) ； 夏德椿(Te-Chun Hsia) ； 程味兒(Wei-Erh Chen) ； 施純明(Chuen-Muen Shih) ； 徐武輝(Wu-Huei Hsu)

《胸腔醫學》 20卷1期 (2005/02) Pp. 17-24

https://doi.org/10.29806/TM.200502.0003

摘要

Background: Community-acquired pneumonia (CAP) is one of the most common causes of severe illness and death in the elderly; however, young adults, although in the minority, are also among the fatalities.
Objective: To describe the clinical outcomes and identify the risk factors associated with CAP mortality in young adults.
Method: We retrospectively reviewed the records of 490 young adult patients (15-50 years old) admitted to our hospital with the diagnosis of community-acquired pneumonia from January 2001 to December 2002. We used the pneumonia severity index (PSI) to stratify these 490 patients into different risk groups. Of this group, 19 died of severe CAP. The factors associated with mortality in these young adults were analyzed.
Results: Higher degrees of severity in the PSI risk groups led to significantly increased mortality in the young adults patients with CAP (group Ⅰ (0.58%), group Ⅱ (1.25%), group Ⅲ (6.67%), group Ⅳ (33.33) and group Ⅴ (50.00%)). Factors affecting mortality included malignancy, liver disease, altered mental status, respiratory rate ＞30/min, systolic blood pressure ＜90 mmHg, pulse rate ＞125/min, pH ＜7.35, BUN ＞30 mg/dl, glucose ＞250 mg/dl, hematocrite ＜30%, partial pressure of arterial oxygen ＜60 mmHg, and pleural effusion on the chest radiograph. Using logistic regression analysis, only age and blood urea nitrogen ＞30 mg/dI were significant factors associated with mortality.
Conclusion: In our series, severity and PSI grouping could predict, with excellent results, the outcome of young adults with CAP. In the analysis of factors affecting the clinical outcome, age and blood urea nitrogen ＞30 mg/dl had the greatest impact on mortality in young adults with CAP.

關鍵字

社區性肺炎 ； 年輕人

並列摘要

Background: Community-acquired pneumonia (CAP) is one of the most common causes of severe illness and death in the elderly; however, young adults, although in the minority, are also among the fatalities.
Objective: To describe the clinical outcomes and identify the risk factors associated with CAP mortality in young adults.
Method: We retrospectively reviewed the records of 490 young adult patients (15-50 years old) admitted to our hospital with the diagnosis of community-acquired pneumonia from January 2001 to December 2002. We used the pneumonia severity index (PSI) to stratify these 490 patients into different risk groups. Of this group, 19 died of severe CAP. The factors associated with mortality in these young adults were analyzed.
Results: Higher degrees of severity in the PSI risk groups led to significantly increased mortality in the young adults patients with CAP (group Ⅰ (0.58%), group Ⅱ (1.25%), group Ⅲ (6.67%), group Ⅳ (33.33) and group Ⅴ (50.00%)). Factors affecting mortality included malignancy, liver disease, altered mental status, respiratory rate ＞30/min, systolic blood pressure ＜90 mmHg, pulse rate ＞125/min, pH ＜7.35, BUN ＞30 mg/dl, glucose ＞250 mg/dl, hematocrite ＜30%, partial pressure of arterial oxygen ＜60 mmHg, and pleural effusion on the chest radiograph. Using logistic regression analysis, only age and blood urea nitrogen ＞30 mg/dI were significant factors associated with mortality.
Conclusion: In our series, severity and PSI grouping could predict, with excellent results, the outcome of young adults with CAP. In the analysis of factors affecting the clinical outcome, age and blood urea nitrogen ＞30 mg/dl had the greatest impact on mortality in young adults with CAP.

並列關鍵字

community-acquired pneumonia ； young adult ； outcomes