prognosis

Last reviewed 01/2018

Some information concerning the prognosis in pneumonia is given below:

• community-acquired pneumonia (CAP) has an incidence rate of around 1 case per 1000 population per year in the EU and is associated with considerable morbidity and mortality worldwide, with up to 68.8% of patients requiring hospitalization

• adverse prognostic factors include:
• age - highest mortality in very young and elderly
• respiratory rate >= 30/min } if >=2 are
• diastolic blood pressure <= 60mm Hg} present then x21
• blood urea > 7 mmol/l } inc. in mortality
• confusion
• leucocyte count > 20 or < 4 x 10^9/l
• serum albumin < 35 g/l
• arterial oxygen tension < 8kPa
• mutiple lobes seen to be affected on chest x-ray
• organism - worst prognosis is associated with type 3 pneumococci, Staph. pyogenes and Klebsiella pneumoniae
• bacteraemia increases mortality
• concomitant disease, e.g. chronic bronchitis or emphysema

• lung abscesses (2%) or empyemata (1%):
• are complications of inadequately treated pneumonia
• indicate a poor prognosis

• lobar or segmental pneumonia are more commonly associated with persistent or recurrent respiratory symptoms

Reference:

• Woodhead M. Community-acquired pneumonia in Europe: causative pathogens and resistance patterns. Eur Respir J Suppl. 2002;14:20s-27s.
• Welte T. Risk factors and severity scores in hospitalized patients with community-acquired pneumonia: prediction of severity and mortality. Eur J Clin Microbiol Infect Dis. 2012;14:33-47