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.
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.