Baseline Predictors of Adverse Outcome and Survival in Adults Hospitalized with Invasive Pneumococcal Disease.

BACKGROUND/

objectivesInvasive pneumococcal disease (IPD) remains associated with substantial mortality. We evaluated whether routinely available baseline variables were associated with 65-day all-cause mortality among adults hospitalized with IPD.

methodsWe conducted a retrospective cohort study of 195 adults hospitalized with IPD. The primary endpoint was 65-day all-cause mortality, with hospital admission as the time origin and administrative censoring at day 65. Logistic regression and Cox proportional hazards models were fitted with a prespecified adjustment set that included age, sex, invasive mechanical ventilation, procalcitonin, and pH.

resultsOverall, 42 patients died during follow-up. Non-survivors had lower admission pH, higher procalcitonin concentrations, and more frequent invasive mechanical ventilation. In the adjusted logistic model, lower pH showed a directionally consistent but non-significant association with mortality (OR per 0.05-unit decrease, 1.45; 95% CI, 0.96-2.20;

conclusionsIn adults hospitalized with IPD, lower admission pH, higher procalcitonin levels, and invasive mechanical ventilation were associated with worse outcomes. Lower pH showed the most consistent prognostic signal, particularly in time-to-event analysis, but estimates were imprecise and should be interpreted as exploratory. These findings support the potential bedside value of early acid-base assessment for risk stratification in IPD.