Analysis Of Factors That Contribute To Treatment Failure In Patients With Community-acquired Pneumonia

Objective: To discuss related factors on CAP treatment failure throughobserving clinical effect of community acquired pneumonia (CAP) treatmentafter72h in a community.Method: It collects149patient cases that in Respiratory MedicineDepartment of Bethune First Hospital of Jilin University from January2013toJanuary2014, who are confirmed as CAP initially and are not in compliancewith exclusion criterion. The study records basic information of patients,complicated underlying diseases, laboratory data and imaging inspection,CRB-65score,72h treatment, prognosis and other conditions. According to theclinical effect after72h of treatment, it is divided in an effective group with117cases and ineffective group with32cases, and applies SPSS statistics softwareto take review analysis for CPA treatment failure related risk factors. p<0.05andit has statistical difference.Result: Involved149cases of CAP patients, the average age is (60.40±14.00) years old. It has89male cases and60female cases,83cases of smokers,26cases of alcoholism,4cases of drug taking history and15cases ofdisturbance of consciousness. Complicated basic disease mainly includes88cases of cardiovascular diseases,22cases of neurological diseases,22cases ofprevious aspiration pneumonia and11cases of diabetes mellitus. Main clinicalsymptoms include141cases of cough (95%),135cases of sputum (91%),54cases of chest pain (36%) and46cases of dyspnea (31%),136cases with signsof lung auscultation and moist rales (91%). Among the149cases of patients, ithas117cases of effective treatment and32cases of ineffective treatment.Aetiology mainly includes42cases of streptococcus pneumoniae (28%),24 cases of fungal (16%) and10cases of Pseudomonas aeruginosa (6.7%).Compared with the effective group and ineffective group, risk factors of singlefactor analysis with statistical difference are: age, complicated neurologicaldiseases, diabetes mellitus and previous aspiration pneumonia, CURB-65score,respiratory rate, body temperature, arterial partial pressure of oxygen, percentageof neutrophils, CRP, lesions of left lung lobe and multiple lung lobes, fungal andStaphylococcus aureus infection, p<0.05.Conclusion:1. CAP treatment failure ratio in our hospital is21%，moreconsistent with related domestic and abroad studies.2. Related factors of CAP treatment failure are quite complicated. The hostfactors are in dominant. On aetiology aspect, it shall guard against fungi andGram-positive cocci infection.3. CURB-65score can predict the effectiveness of CAP diagnosis andtreatment to some extent. It shall pay attention to the application in clinicaldiagnosis and treatment.4. On imaging performance aspect in the study, except multi-lobeinvolvement, which shall guard against CAP diagnosis and treatment failure,pure lesions of left lung lobe is also a risk factor for the appearance of CAPdiagnosis and treatment failure. Therefore, it shall attach importance in clinicaldiagnosis and treatment activities.