Inclusion Criteria:  18 and over age, hospital-acquired pneumonia, emergency department admissions  Exclusion Criteria:  Patients who are pregnant or lactating, under 18 years of age, in the healthcare-associated pneumonia group, had mechanical ventilation at the last hospitalization, whose lactate level could not be studied for any reason at admission and 6th hour, had missing data used in pneumonia severity index calculation and/or who did not accept to participate in the study