Prediction of community-acquired pneumonia complications in military men

Aim. To develop diagnostic algorithm to predict the risk of community-acquired pneumonia development. Methods. 2000 patients with community-acquired pneumonia (male conscripts aged 18 to 22 years, mean age 19.2±0.19). A comparative analysis of two groups of patients to assess the algorithm for toxic shock syndrome, acute respiratory failure and acute kidney injury prediction was performed. In the comparison group (n=782, 1998 to 2003), prediction of complications was based on doctors’ personal knowledge and experience without using the prediction algorithms. In the main group (n=1218, 2003 to 2008), the established prediction algorithm was used. Results. The introduction of community-acquired pneumonia complications prediction algorithm allowed to decrease the incidence of such complications significantly. Toxic shock syndrome was diagnosed in 8.8% of patients in the comparison group and in 3.7% of patients of the main group (р <0.05), acute respiratory failure - in 43.1% of patients of the comparison group and in 19.5% of patients of the main group (р <0.05). The effectiveness of the algorithm for toxic shock syndrome prognosis was 90.8%, sensitivity - 91.8%, specificity - 89.7%, accuracy - 94.5%. The effectiveness of the algorithm for acute kidney injury prognosis was 90.7%, sensitivity - 90.7%, specificity - 90.8%, accuracy - 95.1%. Conclusion. Offered prediction algorithms can help a physician to suspect a possibility of potentially dangerous and lethal complications development in patients with community-acquired pneumonia at the early stages of the disease. It allows to adjust the treatment, to simplify the estimate for transportation need, to detect the indications for patients admission, including the admission to intensive care unit, and improve the results of treatment.

community-acquired pneumonia, prognosis, algorithm, semiotics, complications, males, conscripts