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P210 Community Acquired Pneumonia- Severity and Mortality
  1. K Tariq,
  2. P McDermott,
  3. S Sunny,
  4. H Burhan,
  5. J Hadcroft
  1. Royal Liverpool and Broadgreen University Hospitals, Liverpool, UK

Abstract

Background Community acquired pneumonia (CAP) is a common cause of hospital admissions and carries a high mortality rate. Risk stratification through clinical assessment, underlying chronic lung disease, SIRS and CURB65 helps identify patients at moderate to high risk of mortality. Despite prompt and appropriate management, a significant number of patients (18.3%) die in hospital (BTS Adult CAP audit 2009/10).

Aims and objectives We wished to determine our hospital’s CAP mortality rate and ascertain the proportion of patients with a high likelihood of death, as predicted by high CURB-65 scores, markers of severe infection (SIRS criteria) and underlying chronic respiratory disease.

Methods Case notes of all patients admitted with CAP over a 3 month period were requested and 175 were obtained. Information was gathered on the presence of underlying chronic lung conditions, CAP severity/mortality markers (SIRS and CURB65 scores) and mortality.

Results At least one underlying chronic pulmonary condition was found in 45.1% (n = 79), the commonest being COPD (n = 56). CURB65 score was 0 to 1 in 39.4% (low risk), 2 in 27.4% (moderate risk), 3–5 in 17.2% (high risk) and not done in 16% (n = 28). SIRS criteria were met in just under half of the cases (48.5% n = 85).

An in-patient mortality review during this study period showed that 8% (n = 14) CAP patients died in hospital within 30 days. An association of these patients with background lung condition, CURB65 and SIRS is shown in Table 1.

Abstract P210 Table 1

Characteristics of CAP patients who died in hospital within 30 days (n = 14)

Conclusion We showed an improvement in mortality figures compared with the BTS National CAP adult audit 5 years ago (8% vs 18.3%). A significant number of these patients have an underlying chronic lung disease which predisposed them to developing CAP. The highest mortality was seen in patients with a high CURB65 score with SIRS response.

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