1Internal Diseases, Kazan State Medical University, Kazan, Russian Federation
Some factors besides treatment can significantly influence on the fatal outcomes of pneumonia. Objective. Identification of non-medication risk factors of death based on study of the inpatients clinical signs of pneumonia. Methods. Retrospective analyze of 62 case histories of patients died from pneumonia in hospitals: 12 women and 50 men of 30 to 88 years. Results. 24% of patients had constant job, 76% were not working. 21% of patients had a disability for chronic diseases. The beginning of disease averaged 5,4 days before hospitalization. The recourse was on average 1 day before hospitalization. The most frequent complaints were cough (10% with hemoptysis), weakness and dyspnea. 45% of patients smoked. 50% abused alcohol. Dipsomania preceded hospitalization in 40% of cases. 10% had a drug addiction, 5% were HIV-positive, 13% had chronic viral hepatitis B and C. Leading role of cardiovascular (66%) and gastrointestinal (65%) pathology have been revealed.
Based on dates of autopsies, attention should be paid to alcoholic genesis of these diseases. Coronary heart disease and hypertension took place much rarer. In 40% we observed various stages of consciousness disturbance from mild lethargy to coma. In 69% we saw skin and mucosa cyanosis, in 63% - tachypnea, 55% - hypotension. 57% had body mass deviations. In 63% we observed bilateral pneumonia, in 33% - pleural effusion. Conclusions. Social status, late hospitalization, smoking, alcoholism, alcoholic genesis of comorbidity, deviation of the mental, nutritive status, bilateral pneumonia, pleural effusion, hemodynamic disorders should be recognized as non-medication predictors of fatal outcome, requiring early attention and subsequent correction of treatment.