[An addition to the clinical algorithm for treatment of patients with community-acquired pneumonia in Bosnia-Herzegovina: a multicenter prospective study in Sarajevo].
The Patient Pneumonia Outcomes Research Team (PORT) has developed a scoring system that allows the severity of illness to be quantitatively measured. Using an algorithm, the patient can be classified as to risk. The total number of points assigned to the patient increases risk of poor outcome. Patients in risk classes I, II and III have an expected mortality (< 5%) and should be managed as outpatients. Patients with risk class IV and V have mortality rates of 8-29% and should be admitted to the hospital. Patients with risk class V will usually require intensive care.


OBJECTIVE
We started a multicenter prospective study in Sarajevo, to investigate some differences in demographic factors, comorbid diseases, physical examination findings, laboratory findings, the duration, complications and mortality in our population with CAP, than in recommended algorithm.


METHODS
We recorded the cases of 163 patients (100 male, 63 female) with mean age 58.6 years (17-91). The sample was statistical elaborated with tests of distribution frequency and hi square test.


RESULTS
Between demographic factors, as significant, beside age, there was nicotine abuse in 53% (for our CAP population). In comorbid diseases as significant disease beside preexisting cancer (10.5%), chronic liver disease (4%), renal disease (13%), congestive hearth failure (27%), cerebrovascular disease (5%), there was COPD (31%) and diabetes mellitus (9%). Some differences were in physical examination findings, and laboratory findings. The duration of illness, complications and mortality in our CAP population was like in other studies.


CONCLUSIONS
This work speaks us that our CAP population has some differences in observed characteristics of scoring system. But, without regard to all this, patients with following characteristics should also be admitted to an intensive-care unit and would be classified as patients with severe pneumonia: hypotensia (systolic blood pressure < 90 mm Hg), impending respiratory failure that may require mechanical ventilation, hypoxaemia (pO2 < 60 mm Hg), hemodynamic instability, heart failure, diabetes mellitus (tip I), COPD, poor dental hygiene (anaerobes--necrotizing pneumonia, empyema, abscess).
Mehić
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Klinika za plućne bolesti i tuberkulozu Podhrastovi, Klinicki centar Univerziteta u Sarajevu.
Dizdarević
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Zutić
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D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D017522:Bosnia and Herzegovina; D017714:Community-Acquired Infections / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate
Dodatak klinickom algoritmu u vodenju pacijenata sa općestecenim pneumonijama u Bosni i Hercegovini: multicentricna prospektivna studija u Sarajevu.