Analysis of complication’s frequency of community-acquired pneumonia in military personnel during hostilities

Abstract

The article presents the main clinical manifestations, laboratory indicators, and the frequency of complications of non-hospital pneumonia of a severe course in military personnel during hostilities. The purpose of the work is to determine the frequency of development of complications of severe acute renal failure in servicemen during hostilities. Material and methods. 46 male military personnel with severe CAP, who were undergoing examination and inpatient treatment at the pulmonology clinic of the National Medical Center «HVKG» of the Ministry of Defense of Ukraine during the period from February 2022 to December 2023 were examined. A retrospective analysis of 50 inpatient medical cases of patients with severe CAP, who were undergoing examination and inpatient treatment at the pulmonology clinic of the NMMCC «HVKG» of the Ministry of Defense of Ukraine for the period 2016-2021 was conducted. The patients were divided into two groups: 1st group consisted of 46 servicemen on mobilization who fell ill with a severe CAP during hostilities, the average age of the patients in this group was 42.4±3.9 years; The 2nd group consisted of 50 servicemen who had suffered with CAP, but did not actively participate in hostilities, whose average age was 41.8±4.1 years. Results and discussion. The analysis of the clinical characteristics of the patients showed that the groups were matched by age and sex. Body mass index (BMI) had no significant differences among themselves. In 1 group of patients, 47.8% (22 patients) had a 6-month history of various wounds (mine-explosive trauma, acubarotrauma, chest contusions, shrapnel wounds). Associated pathology in 1 group of patients was represented by gastroesophageal refluxe disease (GERD) – 34.8% (16 patients), non-alcoholic fatty liver disease – 39.1% (18 patients), duodenal ulcer disease – 19.6% (9 patients), COPD – 32.6% (15 patients), bronchial asthma – 17.4% (8 patients), hypertensive disease of stage I and II – 54.4% (25 patients). Among the accompanying diseases, acute sinusitis was detected in patients of group 2 – 24.0% (12 patients), hypertension of the I and II stages – 32.0% (16 patients), GERD – 34.0% (17 patients). It was established that the percentage of people who received antibacterial therapy during the last three months in group 1 of patients was higher and amounted to 47.8% (22 patients), and in group 2 it was 22.0% (p<0.05). It should be noted that the complications that caused the severe course of CAP in 1 group of patients were mainly: exudative pleurisy – 52.2%, lung abscess (destructive pneumonia) – 47.8%, toxic nephropathy – 23.9%, reactive hepatitis – 19.6%. At the same time, a higher percentage of patients with ITS (34.0%) and almost the same percentage of exudative pleurisy, lung abscess, and toxic nephropathy were found in the 2nd group of patients. Attention is drawn to the fact that in both groups of patients a combination of 2 or more complications was observed in the same patient. Conclusions. It was established that a large number of cases (47.8%) of severe CAP during hostilities is observed in military personnel in the first 6 months after injury. A high percentage of pulmonary complications (destructive pneumonia, lung abscess, exudative pleurisy) in military personnel participating in combat operations was revealed.