ABSTRACT
AIM: To reveal the clinical and morphological features and predictors of a fatal outcome in patients with community-acquired pneumonia. MATERIAL AND METHODS: The results of almost 6,500 autopsies were studied; out of them there were 1631 (25%) deaths from pneumonia: 134 and 1497 cases occurring at home and at hospital, respectively. RESULTS: Both groups were considered in terms of pneumonia as a primary disease or as a fatal complication, with 6.4% having the former and 93.6% having a fatal complication of chronic obstructive pulmonary disease, chronic alcohol intoxication, cardiovascular diseases, or cancers. After negative prognosis assessment using the CURB-65 scale, pneumonia was rated as severe and requiring admission to the intensive care unit in 92% of the cases; PORT scale assessment showed that 60% cases of pneumonia necessitated hospitalizations to these units. The major clinical and morphological form of pneumonia was established to be disseminated, lobular, or overwhelming. CONCLUSION: In practice, risk factors for death are underestimated; the disease course is not monitored; current diagnostic and therapeutic approaches are inadequately applied.
