SESSION TITLE: Chest infections Posters II
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM
PURPOSE: To look at outcomes of MSSA pneumonia and identify predictors of bad outcome
METHODS: We used the Nationwide Inpatient Sample (NIS) database to identify patients with MSSA pneumonia through ICD-9-CM code 482.41 from years 2009-2011. We studied three outcomes, Mortality, Length of stay (LOS) and Acute respiratory distress syndrome (ARDS). We also looked at whether age, gender or Charlson's comorbidity index (CCI) had any impact on these outcomes. We used logistic regression for estimation of odds ratio for ARDS and mortality and linear regression for the logarithm of LOS. All analyses were adjusted for the survey design.
RESULTS: There were 16582 records with MSSA pneumonia from 2009 through 2011, representing 82174 discharges nationwide. The overall mortality of patient with MSSA pneumonia was 12.9%. 22.1% of patients had a LOS > 20 days. The percentage of patient with MSSA pneumonia who had ARDS was 1%. Impact of CCI: the estimated odds ratio for a 1 point increase in CCI for ARDS was 1.00 (95%CI 0.92-1.09, p value 0.95), for mortality, it was 1.10 (95%CI 1.08-1.12, p value <0.0001) and for LOS, it was 1.01 (95%CI 0.999-1.013, p value 0.08) Impact of age: the estimated odds ratio for a 10 year increase in age for ARDS was 0.97 (95%CI 0.88-1.07, p value 0.52), for mortality, it was 1.25 (95%CI 1.21-1.28, p value <0.0001) and for LOS, it was 0.95 (95%CI 0.941-0.957, p value <0.001) Impact of gender: the odds ratio for gender (male is baseline) for ARDS was 1.060 (95%CI 0.78-1.45, p value 0.69), for mortality, it was 0.86 (95%CI 0.78-0.96, p value <0.0043), and for LOS, it was 0.93 (95%CI 0.905-0.952, p value <0.0001)
CONCLUSIONS: MSSA pneumonia has a mortality of 12.9%. From our analysis, it seems that all three variables of age, gender and CCI affect mortality. A 10 year increase in age raises the odds of mortality by 25%. A rise in CCI by 1 increases the odds of mortality by 10%. Women have 14% less odds of dying than men. ARDS seems to not be affected by any of these variables to a significant degree. In case of the LOS, a 10 year increase in age decreases the LOS by 5%, Being female reduces the LOS by 7%. CCI does not seem to significantly affect the LOS
CLINICAL IMPLICATIONS: MSSA pneumonia mortality is higher for older patients with more co-morbidities. Presence of ARDS does not seem to be affected by any of these variables. Females have a lower mortality and lower LOS.
DISCLOSURE: The following authors have nothing to disclose: Ezza Khan, Saqib Baig, Aniko Szabo, Nicholas DeVogel
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