Background: Community-acquired pneumonia (CAP) remains a major cause of morbidity and mortality worldwide, particularly in low- and middle-income countries. Identifying predictors of poor outcomes is essential to optimize early management and reduce mortality. Objective: To determine the clinical, laboratory, and radiological predictors of in-hospital mortality among patients hospitalized with CAP in a tertiary-care hospital in Pakistan. Methods: A retrospective observational study was conducted at the Department of Medicine, Nishtar Medical University and Hospital, Multan, from June 2024 to May 2025. Medical records of 100 adult CAP patients were reviewed. Demographic, clinical, and biochemical variables were analyzed. Disease severity was assessed using the CURB-65 score. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of mortality. Results: The mean age of patients was 59.3 ± 15.7 years; 62% were male. Overall in-hospital mortality was 21%. Factors significantly associated with mortality included age ≥ 65 years, diabetes, COPD, chronic kidney disease (CKD), tachypnea, hypotension, altered consciousness, raised urea and creatinine, hyponatremia, multilobar infiltrates, and high CURB-65 scores. Multivariate analysis identified four independent predictors: age ≥ 65 years (AOR 5.21, p = 0.021), CKD (AOR 4.92, p = 0.035), hypotension (AOR 4.37, p = 0.046), and CURB-65 ≥ 3 (AOR 6.45, p = 0.013). Conclusion: Advanced age, renal dysfunction, hypotension, and high CURB-65 scores independently predict mortality in CAP. Early identification and aggressive management of high-risk patients can improve outcomes in resource-limited settings.
Shabbir et al. (Sun,) studied this question.