Anamnesis as mortality prognosis in the community acquired pneumonia

Abstract

Introduction: community acquired pneumonia is an important health problem around the world, and in Cuba it is the fourth cause of death.  Prognostic indexes help to detect early the patients at high risk, but they have low sensibility and specificity.
Objectives: to determine the mortality prognostic factors in the community acquired pneumonia during the anamnesis.
Method: analytic, retrospective, longitudinal study in a group applying non-parametric tests and relative risk calculation.
Results: age: 78 ± 10 years; 53 % of women. Global mortality of 57 %; 53 % had antecedents of diabetes mellitus; 34 % had previous cerebro-vascular disease, and 42 % were bedridden patients. 38 % was sick more than five days and 69 % took antimicrobials before being admitted. 23 % suffered congestive heart failure and 73 % chronic obstructive pulmonary disease. Confusional syndrome was a good predictor of mortality (x2=0.05) (RR=2.8). Long confinement to bed did not predict mortality at the fifth day (x2=0.43). The previous use of antimicrobials increased the risk (RR=0.8) con (x2=0.05). Heart failure was the best predictor (x2=0.006) (RR=1.2). Chronic obstructive pulmonary disease predicted with (x2=0.019) y (RR=1.47).
Conclusions: antecedents of heart failure and chronic obstructive pulmonary disease, and the patient arriving with confusional syndrome   are considered strongly predictive factors.