Akdeniz University Hospital Chest Diseases retrospective evaluation of patients diagnosed with pneumonia in their clinic between 2018-2020

It was aimed to evaluate the demographic, clinical, laboratory and radiological characteristics, diagnosis and treatment approaches, treatment results, length of stay and mortality rates of 204 patients followed up in our clinic with the diagnosis of pneumonia between 2018-2020. Between 10.11.2018-10.11.2020 in Akdeniz University Hospital Chest Diseases Clinic; Patients diagnosed with ICD10 code J18-J14 and its lower divisions (pneumonia) were scanned retrospectively from the hospital automation system. Of the patients, 123 (60.3%) were male and 81 (39.7%) were female, with a mean age of 63.25±17.24 years. Additional disease was present in 172 (84.4%) of 204 patients; Of these, 58 (33%) had hypertension, 50 (29%) had diabetes mellitus, 33 (19.1%) had COPD, while the others had asthma, cerebrovascular accident, heart failure, and malignancy, respectively. It was observed that blood cultures were taken from 104 (49%) patients and a pathogen was detected in 4 (3.8%) patients, and antibiotic treatment in 2 patients was changed according to result. Sputum tests were obtained from 126 (61.7%) patients, and 48 (38.2%) of a pathogen was detected, and a total of 72 microorganisms were isolated from them. According to the incidence of these microorganisms, 11 (15%) were found to be Klebsiella pneumoniae and 8 (11.1%) were Pseudomonas aeruginosa. It was determined that antibiotic treatment was changed in 10 of 48 patients according to the culture results. The sputum tests of 17 (35.4%) of 48 patients was resistant to the current antibiotic, and it was observed that the antibiotics of only 5 (10.4%) patients were changed. Influenza Virus was detected in 6 (2.9%) of 204 patients. Amoxicillin-clavulanic acid/ampicillin-sulbactam + clarithromycin and 62 (25.8%) quinolones were started in 64 (26.6%) patients. It was observed that the initial empirical antibiotic therapy of 58 (28.4%) patients was changed. It was observed that 1 of 11 patients who were started on cephalosporin was started at the hospital, 10 of them were started before hospitalization, and the treatment of all of these patients was changed. It was observed that patients with a high PSI risk score needed NIMV and intensive care and were more likely to have complicated pneumonia, but the 28-day mortality rates of these patients were not different. It was observed that the PSI risk scores of the patients with a pathogen was detected sputum tests and blood cultures were mostly 4 and 5 (p=0.01). Older patients had longer hospital stays and higher mortality rates (p=0.03, p=0.04, respectively). It was observed that patients with complicated pneumonia had a longer hospital stay (p=0.03). Mortality rates were found to be higher in patients with low GFR (p=0.03). The PSI risk score of the group with the most antibiotic changes was found to be 5 (p=0.02). It was observed that the PSI risk scores of the patients who were admitted to the hospital with pneumonia again within 1 month after discharge were mostly 4.5 (p=0.01). It was noted that patients hospitalized with the diagnosis of pneumonia had more advanced age and additional disease. Advanced age, high PSI score, complicated pneumonia, and decreased GFR were associated with mortality. It was determined that the evaluation of the PSI risk score together with the clinic was effective in predicting the prognosis in the patients at the time of admission. In our study, sputum tests and blood culture results were found to be limited in guiding clinical follow-up and treatment.