Comparative efficacy of serum NT-proBNP versus AST for detecting cardiac dysfunction in diabetic patients with heart disease

Abstract

Background & objective: Community-acquired pneumonia (CAP) stands as one of the most widespread infections globally, often leading to hospital admissions. This study aims to assess the proportion and mortality rate of severe CAP patients admitted to the Intensive Care Unit (ICU) and to identify the significant predictor factors contributing to mortality.

Methods: The study was conducted as a retrospective cohort study of severe CAP patients admitted to the mixed ICU and surgical ICU of Hospital Pakar University Sains Malaysia (HPUSM) during two years from January 1, 2021, to December 31, 2022. Eligible participants were adults aged 18 years and older diagnosed with severe CAP, with demographic, clinical, laboratory, and outcome data retrospectively collected from records and registries.

Results: A total of 203 severe CAP patients out of 788 were admitted to the ICU, indicating a prevalence of 25.8%, with a mortality rate of 25.6%. The mean age was 54.66 years.  Multiple logistic regression analysis revealed that the independent risk factors significantly associated with mortality were an APACHE II score exceeding 23 (adjusted Odd Ratio OR = 7.89; 95% CI: 2.88, 21.61; P < 0.001). And plasma albumin level (adjusted OR = 0.92; 95% CI: 0.86, 0.99; P = 0.025).

Conclusion: The prevalence of severe CAP in the ICU at HPUSM was 25.8%, with a mortality rate of 25.6%. Higher APACHE II scores were associated with mortality, while elevated plasma albumin levels were associated with lower mortality in ICU.

Abbreviations: CAP: Community-acquired pneumonia, DM: Diabetes mellitus, DNR: do-not-resuscitate, GCS: Glasgow Coma Scale. ICU: Intensive Care Unit, PSI: Pneumonia Severity Index, MRIC: Malaysian Registry of Intensive Care, SICU: Surgical Intensive Care Unit

Keywords: Community-acquired pneumonia; CAP; intensive care; prevalence; mortality risk factors; mortality; predictor risk factors

Citation: Goh SL, Hassan SK, Shukeri WFWM, Azmi NAM, Yaacob NM, Mazlan MZ. Prevalence and predictors of mortality in patients with severe community-acquired pneumonia in the intensive care unit. Anaesth. pain intensive care 2025;29(9):1209-16. DOI: 10.35975/apic.v29i9.3053

Received: August 17, 2025, 2025; Revised: September 07, 2025; Accepted: September 09, 2025