Muhammet Ali ERİNMEZ, Kadir Burak AKGÜN, Mesut YEŞİLOVA, Raşit BAYSAL
Experimental Biomedical Research - 2026;9(4):238-250
Aim: To investigate the prognostic value of pulmonary artery (PA) diameter, ascending aortic (Ao) diameter, and the pulmonary artery-to-aorta diameter ratio (PA/Ao ratio) measured on thoracic computed tomography (CT) in patients hospitalized with community-acquired pneumonia (CAP). Methods: This retrospective observational study included adult patients hospitalized with CAP between January 2020 and April 2024. Demographic, clinical, laboratory, and radiological data were collected from electronic medical records. PA and Ao diameters were measured on thoracic CT scans, and the PA/Ao ratio was calculated. The primary outcome was defined as a composite of in-hospital mortality, intensive care unit admission, or requirement for mechanical ventilation. Receiver operating characteristic (ROC) analysis and logistic regression models were used to evaluate prognostic performance and identify independent predictors of poor outcomes. Results: A total of 200 patients were included, and 107 (53.5%) experienced the primary outcome. Patients with poor prognosis were significantly older and had higher lactate levels, lower oxygen saturation, and higher frequencies of heart failure and malignancy. Although PA diameter, Ao diameter, and PA/Ao ratio were numerically higher in patients with poor outcomes, none demonstrated a significant independent association with prognosis. ROC analyses showed limited discriminatory performance for PA diameter (AUC: 0.578), Ao diameter (AUC: 0.583), and PA/Ao ratio (AUC: 0.528). Multivariable logistic regression identified elevated lactate levels (OR: 1.369, p=0.004), lower oxygen saturation (OR: 0.901, p<0.001), and heart failure (OR: 2.936, p=0.008) as independent predictors of poor prognosis. Conclusions: PA diameter, Ao diameter, and the PA/Ao ratio measured on admission thoracic CT were not useful predictors of poor outcomes in hospitalized CAP patients. Clinical and physiological parameters, particularly oxygen saturation, lactate level, and heart failure, provided superior prognostic information and should remain the cornerstone of risk stratification in CAP.
