Factors Associated with Early Mortality within 48 Hours among Deceased Patients with Community-Acquired Pneumonia at Lomkao Crown Prince Hospital, Phetchabun, Thailand

Abstract

Community-acquired pneumonia (CAP) is a major cause of hospitalization and mortality, particularly during the early phase after admission. However, data regarding factors associated with early mortality within 48 hours remain limited. This study aimed to determine the case fatality rate and identify factors associated with early mortality within 48 hours among patients with CAP at Lom Kao Crown Prince Hospital. A retrospective cohort study was conducted by reviewing medical records of deceased CAP patients between April 1, 2018, and April 30, 2025. Data collected included demographic characteristics, clinical parameters at admission, laboratory findings, and treatment-related variables. Descriptive statistics and both univariate and multivariate logistic regression analyses were performed, with statistical significance defined as p < 0.05. The overall case fatality rate was 10.7%. Multivariate analysis demonstrated that tachypnea (respiratory rate >25 breaths per minute) and severe metabolic acidosis (pH <7.20) were significantly associated with early mortality within 48 hours, with adjusted odds ratios of 10.99 (95% CI: 1.95–61.95; p = 0.007) and 14.39 (95% CI: 3.78–54.82; p < 0.001), respectively. These findings suggest that tachypnea and severe metabolic acidosis may serve as early warning indicators for high-risk patients with CAP, supporting timely risk stratification and clinical management. Future prospective cohort studies are warranted to validate these findings and enhance the robustness of the evidence.