The Epidemiological Characteristics and Factors Associated with Severe Symptoms in Patients with Pneumonia Admitted to Chumphae Hospital

Abstract

This retrospective descriptive study aimed to study the epidemiological characteristics and factors associated with severe symptoms in patients with pneumonia admitted to Chumphae Hospital. The population were community-acquired pneumonia patients aged more than 15 years old and received inpatient treatment at Chumphae Hospital from January 1, 2021, to December 31, 2023, 956 patients. General and pneumonia information were collected from medical records and hospital information system and analyzed using descriptive statistics and multiple logistic regression. The results revealed that the most were female (50.10%), elderly a mean age of 63.36 years (SD=18.23 years). Most patients were unemployed (44.04%). COVID-19 vaccination coverage was 18.41%, influenza vaccination coverage was only 2.20%. Underlying diseases (79.29%) hypertension was the most common (45.08%), diabetes mellitus (29.92%). COVID-19 pneumonia had 44.87% of cases. The most symptoms were fever and cough (19.25%), dyspnea (16.95%). The highest admitted in rainy (47.18%). The Chest X-ray findings showed ground-glass appearance (40.59%). Blood cultures and sputum cultures were negative in 51.45% of cases. When positive, Klebsiella pneumoniae was the most identified in sputum cultures. At admission time, 44.46% had non-severe pneumonia, 22.17% had moderate severity, and 9.73% had severe pneumonia. Adverse outcomes after admission 349 patients (36.51%) while 50 patients died, case fatality rate was 5.23% (95% CI: 3.82%–6.64%). The analysis factors associated with severe symptoms in patients with pneumonia by multiple logistic regression statistical significant were p-value <0.05. The significant factors were male gender (AOR = 1.69, 95% CI: 1.16-2.45, p=0.006),age >60 years (AOR = 11.48, 95% CI: 6.52-20.24, p<0.001), chronic kidney disease stages 3-5 (AOR = 2.78, 6.82, and 2.89, 95% CI:1.71-4.50, 2.76-16.86 and 1.26-6.65, p <0.001, <0.001, 0.012 respectively), respiratory rate (AOR=1.16, 95% CI:1.12-1.20, p-value<0.001), oxygen saturation (AOR =0.96,95% CI:0.93-0.98, p-value=0.003) and Hemoglobin level (AOR = 0.84, 95%CI:0.77-0.91, p-value <0.001). Conclusion the factors significantly associated with severe pneumonia at initial admission include: age >60 years, male gender, chronic kidney disease, respiratory rate, oxygen saturation at admission and hemoglobin level. These findings can be used to guide screening and monitoring of high-risk patients in community settings and management for influenza vaccine.