%0 Journal Article %A Darina Miteva %A Yordan Radkov %A Vanya Kostadinova %A Anna Dyakova %T The impact of comorbidities on the in-hospital mortality in patients with community-acquired pneumonia %D 2015 %R 10.1183/13993003.congress-2015.PA1840 %J European Respiratory Journal %P PA1840 %V 46 %N suppl 59 %X Introduction: Community-acquired pneumonia is a common disease with frequent hospitalization and still high mortality rate. The influence of comorbid illnesses on the course of pneumonia is often underestimated.Aim: To evaluate the impact of comorbidities on the in-hospital mortality in patients with CAP.Materials and Methods: 1203 patients hospitalized with CAP for the period of 3 years 2012-2014 were retrospectively studied. Data were analyzed with SPSS.20. χ2-test, univariate analysis and ROC-curve were performed.Results: The patients were on average age 59,9±17,1 years, 56,2%-male, 43,8%-female. Comorbidities had 68,3%. The most common comorbidities were: ishaemic heart disease (24,5%), diabetes mellitus (23,6%), chronic heart failure (23,5%) and cerebrovascular disease (17,2%). Patients with dementia (OR 6,85; 95% CI 5,97- 11,86), cancer with metastases (OR 4,33; 95% CI 1,4-13,1); cerebrovascular disease (OR 4,05; 95% CI 2,77-5,92) and chronic renal failure (OR 3,66; 95% CI 2,35-5,73) had the highest risk of dying in the hospital. The total mortality rate was 11,7%. In patients with comorbidities it was 15,8%; without comorbidities-2,9% (p<0,001).The mean Charlson Comorbidity Index (CCI) was 1,58. It was significantly higher for nonsurvivors than for survivors (3,28 vs. 1,36 p<0,001). CCI was a good predictor of in-hospital mortality although its predictive value was lower than this of the basic scales (AUC for PSI, IDSA/ATS criteria, CURB-65, CRB-65 and CCI were 0,860; 0,845; 0,834; 0,817 and 0,717resp.)Conclusion: Comorbidities increase the risk of in-hospital mortality of patients with CAP and need extra- attention by the physicians. %U