Objectives To evaluate clinical factors associated with mortality from pneumonia among patients with pneumoconiosis.
Methods Medical records of pneumoconiosis patients hospitalised for pneumonia (n = 103) were reviewed retrospectively. Patients who had lung cancer or other malignancy (n = 7) and patients with insufficient medical record (n = 13) were excluded. Female patients (n = 2) were excluded due to small number to analyse. The eligible subjects (n = 81) were divided into two groups by clinical outcome of pneumonia; the deceased group and the survival group. The two groups were compared in terms of age, smoking history, episode of recent pneumonia, concomitancy of interstitial fibrosis or fungal ball infection, type of pneumoconiosis, extent of small opacities, grade of large opacities and results of spirometry. Multiple logistic regression was applied to determine the association between these variables and mortality from pneumonia.
Results The deceased group showed more frequent history of recent pneumonia (p = 0.006), higher prevalence of interstitial fibrosis (p = 0.007) and longer hospitalisation period (p = 0.044). The proportion of subjects who had decreased FVC or FEV1, less than 70% of predicted value, was significantly higher in the deceased group (p < 0.001, P < 0.012). In multiple logistic regression, history of recent pneumonia, concomitancy of interstitial fibrosis, type of pneumoconiosis and fungal ball presented statistically significant association with mortality from pneumonia after adjusting age, smoking history, recent pneumonia, fungal ball, large opacity, type of pneumoconiosis, profusion and FVC (or FEV1) less than 70% of predicted value.
Conclusions The concomitancy of fungal ball or interstitial fibrosis, history of recent pneumonia within last 90 days, type of pneumoconiosis, FVC or FEV1 less than 70% of predicted value presented statistically significant association with mortality from pneumonia. More attention should be given to patients who have such factors when treating pneumonia with pneumoconiosis.
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