title: Risk factors predicting mortality in patients with lung abscess in a public tertiary care center in Karachi, Pakistan.
abstract: BACKGROUND
  Lung abscess is a commonly encountered entity in South-East Asia but not much data regarding its outcome is available. The objective of this study was to identify the factors associated with increased mortality in patients diagnosed with lung abscess in a tertiary care center of Karachi, Pakistan.
  
  
  METHODS
  A retrospective case analysis was performed via hospital records, on patients admitted with lung abscess between January 2009 and January 2011 at the largest state-owned tertiary care centre in Karachi, Pakistan. Out of the 41 patients hospitalized, 17 could not survive and were evaluated for clinical, radiological and microbiological factors to determine association with heightened mortality.
  
  
  RESULTS
  Mortality due to lung abscess stood at 41.4% (17 of 41 cases). Adult male patients were found to have higher mortality with 13 out of 17 (43%) dead patients being male. A majority (21/41, 51.2%) of the cases belonged to the 41-60 year old age group. Highest mortality was seen in patients<20 years of age (3/4, 75%). Patients with blood sugar levels of >200 mg/dL (56%) succumb to disease. Patients with a positive history of smoking, diabetes mellitus, and alcohol intake expressed mortality rates of 44%, 56%, and 50% respectively; while 29.4% of the mortalities were positive for Pseudomonas aeruginosa on sputum culture. A significant association was found with elevated mortality and low haemoglobin levels at time of admission; mortality was 58% (p=0.005) in patients with Hb less than or equal to 10 mg/dL.
  
  
  CONCLUSIONS
  The risk factors involved with heightened mortality included male gender and history of smoking, diabetes and alcohol intake. High blood sugar levels and detection of Pseudomonas aeruginosa on sputum cultures were also implicated. Anemia (Hb level less than or equal to 10 mg/dl) was statistically significant predictive factor for increased mortality.
authors.affiliation: Department of Chest Medicine, Jinnah Postgraduate Medical Center, Karachi, Pakistan.
authors.forename: Shaista
authors.initials: S
authors.lastname: Ghazal
authors.affiliation: Department of Chest Medicine, Jinnah Postgraduate Medical Center, Karachi, Pakistan.
authors.forename: Ashok
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Bolan Medical College, Quetta, Pakistan.
authors.forename: Binav
authors.initials: B
authors.lastname: Shrestha
authors.affiliation: Department of Chest Medicine, Jinnah Postgraduate Medical Center, Karachi, Pakistan.
authors.forename: Sana
authors.initials: S
authors.lastname: Sajid
authors.affiliation: Department of Chest Medicine, Jinnah Postgraduate Medical Center, Karachi, Pakistan.
authors.forename: Maria
authors.initials: M
authors.lastname: Malik
authors.affiliation: Department of Chest Medicine, Jinnah Postgraduate Medical Center, Karachi, Pakistan.
authors.forename: Nadeen
authors.initials: N
authors.lastname: Rizvi
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008169:Lung Abscess / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D011552:Pseudomonas Infections / Q000453:epidemiology; D011550:Pseudomonas aeruginosa; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology; D062606:Tertiary Care Centers; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult