Open AccessPredictors of Long-term Outcomes in the Older Adults with Community-Acquired Pneumonia
Author(s) -
Serkan Sürme,
İ̇lker İnanç Balkan,
Osman Faruk Bayramlar,
Ritvan Kara Ali,
Bilgül Mete,
Fehmı Tabak,
Neşe Saltoğlu
Publication year - 2021
Publication title -
journal of infection in developing countries
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.322
H-Index - 49
eISSN - 2036-6590
pISSN - 1972-2680
DOI - 10.3855/jidc.14881
Subject(s) - medicine , mechanical ventilation , community acquired pneumonia , pneumonia , pneumonia severity index , comorbidity , charlson comorbidity index , univariate analysis , retrospective cohort study , multivariate analysis , emergency medicine
We aimed to determine the indicators for poor long-term outcome in older adults with community-acquired pneumonia (CAP).
Methodology: Patients with CAP requiring hospitalization were included in this retrospective study. The long-term mortality was defined as all-cause 1-year mortality following hospital admission.
Results: A total of 145 patients with CAP were recorded. The median age was 70 (18-103), of whom 94 (65%) were ≥ 65 years old and 86 (59.5%) were male. Long-term mortality rates following CAP requiring hospitalization were substantially high in both the younger (n = 16, 31.4%) and older adults (n=43, 45.7%). In univariate analysis, the Pneumonia Severity Index (PSI) (p = 0.007), mechanical ventilation (p > 0.001), mental status changes (p = 0.018) as well as the modified Charlson Comorbidity Index (p=0.001), presence of malignancy (p < 0.001) and hospital readmission (p < 0.001) were associated with long-term mortality in the older group. Our results revealed that the need for mechanical ventilation (OR = 47.61 CI = 5.38-500.0, p = 0.001) and hospital readmission (OR = 15.87 CI = 5.26-47.61, p < 0.001) were major independent predictors of 1-year mortality.
Conclusions: Clinicians should consider the lethal possibilities of CAP even after hospital discharge. The need for mechanical ventilation and hospital readmission may predict long-term mortality. Therefore, the patients who have these predictors should be closely monitored.