Community-acquired pneumonia: clinic-epidemiological characterization.

Abstract

Introduction: the community-acquired pneumonia is the most frequent cause of death of infectious etiology in the developed countries in the XXI century. It has a high incidence and morbimortality, situation that is worsened by the emergency of communitarian multi resistant germs. The severity prognostic scales are useful tools in the therapeutic- diagnostic confrontation of this disease. Based on that, the authors proposed themselves the objective of characterizing the clinic-epidemiologic behavior of the community-acquired pneumonia, linking it with the CRB-65 scale application.
Methods: descriptive, observational and prospective research on the universe of patients who entered the Teaching Surgical Clinical Hospital Comandante Faustino Perez, of Matanzas, in 2007, for community-acquired pneumonia. We used dialectic-materialist philosophic, empiric, theoretic and statistic methods with variables selection and operationalization, applying summarizing measures.
Results: near 50 % of the patient who assisted the hospital with community-acquired pneumonia were admitted as in-patients, 74,7 % of them were elder than 65 years old; the combined antimicrobial therapy reached 44 %. When the CRB-5 scale was applied more than 60 % had scarce predicted severity; among those who had values predicting severity, 60 % were transferred late to health care units for seriously ill persons. The total mortality was 4,2 %, and 40 % in the health care units for seriously ill persons.
Conclusions: community-acquired pneumonia had a high incidence and was the cause of a frequent hospitalization, mainly in the geriatric population, with associated co-morbidities. In a high proportion the hospitalization was decided in groups of scarce severity, needed of an ambulatory treatment according to the prognostic scale CRB-65; from the other hand there were cases with seriousness criteria   transferred late to the health care units for seriously ill persons.