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Radiological patterns and prognosis in elderly patients with acute Klebsiella pneumoniae pneumonia: A retrospective study

Although Klebsiella pneumoniae pneumonia is an insidious threat among the elderly, the role of radiological features has not been elucidated. We aimed to evaluate thin-section chest computed tomography (CT) features and assess its associations with disease prognosis in elderly patients with acute K....

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Autores principales: Komiya, Kosaku, Yoshikawa, Hiroki, Goto, Akihiko, Yamamoto, Takashi, Yamasue, Mari, Johkoh, Takeshi, Hiramatsu, Kazufumi, Kadota, Jun-ichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9371486/
https://www.ncbi.nlm.nih.gov/pubmed/35960104
http://dx.doi.org/10.1097/MD.0000000000029734
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author Komiya, Kosaku
Yoshikawa, Hiroki
Goto, Akihiko
Yamamoto, Takashi
Yamasue, Mari
Johkoh, Takeshi
Hiramatsu, Kazufumi
Kadota, Jun-ichi
author_facet Komiya, Kosaku
Yoshikawa, Hiroki
Goto, Akihiko
Yamamoto, Takashi
Yamasue, Mari
Johkoh, Takeshi
Hiramatsu, Kazufumi
Kadota, Jun-ichi
author_sort Komiya, Kosaku
collection PubMed
description Although Klebsiella pneumoniae pneumonia is an insidious threat among the elderly, the role of radiological features has not been elucidated. We aimed to evaluate thin-section chest computed tomography (CT) features and assess its associations with disease prognosis in elderly patients with acute K. pneumoniae pneumonia. We retrospectively included elderly patients, admitted for acute K. pneumoniae pneumonia, and investigated thin-section CT findings to determine whether bronchopneumonia or lobar pneumonia was present. The association between the radiological pattern of pneumonia and in-hospital mortality was analyzed. Eighty-six patients with acute K. pneumoniae pneumonia were included, and among them, the bronchopneumonia pattern was observed in 70 (81%) patients. Twenty-five (29%) patients died in hospital, and they had a greater incidence of lobar pneumonia pattern (40% in nonsurvivors vs 10% in survivors; P = .008), low albumin level (2.7 g/dL, range, 1.6–3.8 in nonsurvivors vs 3.0 g/dL, range, 1.7–4.2 in survivors; P = .026) and higher levels of aspartate aminotransferase (30 U/L, range, 11–186 in nonsurvivors vs 23 U/L, range, 11–102 in survivors, P = .017) and C-reactive protein (8.0 mg/dL, range, 0.9–26.5 in nonsurvivors vs 4.7 mg/dL, range, 0.0–24.0 in survivors; P = .047) on admission. Multivariate analysis showed that lobar pneumonia pattern was independently associated with increased in-hospital mortality (adjusted hazard ratio, 3.906; 95% CI, 1.513–10.079; P = .005). In elderly patients with acute K. pneumoniae pneumonia, the lobar pneumonia pattern may be less commonly observed, and this pattern could relate to poor prognosis.
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spelling pubmed-93714862022-08-16 Radiological patterns and prognosis in elderly patients with acute Klebsiella pneumoniae pneumonia: A retrospective study Komiya, Kosaku Yoshikawa, Hiroki Goto, Akihiko Yamamoto, Takashi Yamasue, Mari Johkoh, Takeshi Hiramatsu, Kazufumi Kadota, Jun-ichi Medicine (Baltimore) Research Article Although Klebsiella pneumoniae pneumonia is an insidious threat among the elderly, the role of radiological features has not been elucidated. We aimed to evaluate thin-section chest computed tomography (CT) features and assess its associations with disease prognosis in elderly patients with acute K. pneumoniae pneumonia. We retrospectively included elderly patients, admitted for acute K. pneumoniae pneumonia, and investigated thin-section CT findings to determine whether bronchopneumonia or lobar pneumonia was present. The association between the radiological pattern of pneumonia and in-hospital mortality was analyzed. Eighty-six patients with acute K. pneumoniae pneumonia were included, and among them, the bronchopneumonia pattern was observed in 70 (81%) patients. Twenty-five (29%) patients died in hospital, and they had a greater incidence of lobar pneumonia pattern (40% in nonsurvivors vs 10% in survivors; P = .008), low albumin level (2.7 g/dL, range, 1.6–3.8 in nonsurvivors vs 3.0 g/dL, range, 1.7–4.2 in survivors; P = .026) and higher levels of aspartate aminotransferase (30 U/L, range, 11–186 in nonsurvivors vs 23 U/L, range, 11–102 in survivors, P = .017) and C-reactive protein (8.0 mg/dL, range, 0.9–26.5 in nonsurvivors vs 4.7 mg/dL, range, 0.0–24.0 in survivors; P = .047) on admission. Multivariate analysis showed that lobar pneumonia pattern was independently associated with increased in-hospital mortality (adjusted hazard ratio, 3.906; 95% CI, 1.513–10.079; P = .005). In elderly patients with acute K. pneumoniae pneumonia, the lobar pneumonia pattern may be less commonly observed, and this pattern could relate to poor prognosis. Lippincott Williams & Wilkins 2022-08-12 /pmc/articles/PMC9371486/ /pubmed/35960104 http://dx.doi.org/10.1097/MD.0000000000029734 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Komiya, Kosaku
Yoshikawa, Hiroki
Goto, Akihiko
Yamamoto, Takashi
Yamasue, Mari
Johkoh, Takeshi
Hiramatsu, Kazufumi
Kadota, Jun-ichi
Radiological patterns and prognosis in elderly patients with acute Klebsiella pneumoniae pneumonia: A retrospective study
title Radiological patterns and prognosis in elderly patients with acute Klebsiella pneumoniae pneumonia: A retrospective study
title_full Radiological patterns and prognosis in elderly patients with acute Klebsiella pneumoniae pneumonia: A retrospective study
title_fullStr Radiological patterns and prognosis in elderly patients with acute Klebsiella pneumoniae pneumonia: A retrospective study
title_full_unstemmed Radiological patterns and prognosis in elderly patients with acute Klebsiella pneumoniae pneumonia: A retrospective study
title_short Radiological patterns and prognosis in elderly patients with acute Klebsiella pneumoniae pneumonia: A retrospective study
title_sort radiological patterns and prognosis in elderly patients with acute klebsiella pneumoniae pneumonia: a retrospective study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9371486/
https://www.ncbi.nlm.nih.gov/pubmed/35960104
http://dx.doi.org/10.1097/MD.0000000000029734
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