Poverty as an independent risk factor for in-hospital mortality in community-acquired pneumonia: A study in a developing country population

• DOI: 10.1111/ijcp.13085
• Publication Date: 2018-04-17T18:13:34Z
• Authors: Hassan Jahanihashemi; Mona Babaie; Soroush Bijani; Maryam Bazzazan; Behzad Bijani
• Keywords: Male; Iran; 03 medical and health sciences; 0302 clinical medicine; Risk Factors; Humans; Hospital Mortality; Developing Countries; Poverty; Aged; Aged, 80 and over; 1. No poverty; Pneumonia; Middle Aged; Prognosis; 3. Good health; Community-Acquired Infections; Pleural Effusion; Cross-Sectional Studies; Social Class; Hyperglycemia; Acute Disease; Female; Hyponatremia

Community-acquired pneumonia (CAP) is one of the most severe lower respiratory tract infections with a high in-hospital mortality. The aim of this study was to investigate the socioeconomic and medical risk factors affecting the prognosis of acute pneumonia. The results of this study can mention the value of socioeconomic backgrounds like poverty and illiteracy in clinical practice, even in a well-known biological phenomenon (eg acute pneumonia).In this cross-sectional study, all admitted patients to a tertiary teaching hospital with a diagnosis of community acquired pneumonia in a 12-month period were enrolled. Socioeconomic and demographic characteristics, underlying conditions, clinical manifestations and para-clinical test results at admission registered prospectively. A logistic regression model was conducted using in-hospital mortality as the dependent variable.A total of 621 patients was included in this study. Among them, 47 patients (7.6%) died during the hospitalisation period. In multiple logistic regression analysis, pleural effusion, a higher CURB-65 score, hyponatremia, hyperglycaemia and poverty (being in the lower economic class) were identified as independent risk factors for in-hospital mortality in community-acquired pneumonia.Numerous factors can influence the prognosis of CAP. In addition to the CURB-65 score and some other medical risk factors, socioeconomic backgrounds can also affect the early outcome in CAP. In this study, being in the lower economic class (as an indicator of poverty) is interpreted as an independent risk factor for a poor prognosis in CAP.