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Pneumonia: still the old man's friend?
Vladimir Kaplan1, Gilles Clermont, Martin F Griffin
1Room 604, Scaife Hall, Critical Care Medicine, University of Pittsburgh, 200 Lothrop St, Pittsburgh, PA 15213, USA.
Archives of Internal Medicine
|February 13, 2003
Summary
Nearly half of elderly patients hospitalized with community-acquired pneumonia (CAP) die within a year, often after discharge. This long-term survival is worse than for other hospitalized patients.
Area of Science:
- Geriatric Medicine
- Pulmonology
- Public Health
Background:
- Community-acquired pneumonia (CAP) hospital mortality is known.
- Long-term survival of CAP patients discharged alive requires further investigation.
- Comparison with non-CAP hospitalized patients is needed.
Purpose of the Study:
- To determine the long-term survival of elderly patients hospitalized with CAP.
- To compare the long-term survival of CAP patients with controls hospitalized for other reasons.
Main Methods:
- Matched case-control analysis of Medicare hospital discharge data (1997).
- Comparison of elderly CAP patients (N=158,960) with controls (N=794,333) matched for age, sex, and race.
- One-year mortality assessed using Medicare Beneficiary Entitlement and Social Security Administration data.
Main Results:
- One-year mortality was 40.9% for CAP patients versus 29.1% for controls (P<.001).
- Among survivors, one-year mortality was 33.6% for CAP patients versus 24.9% for controls (P<.001).
- Standardized mortality ratios at 1 year post-discharge were elevated for both groups (2.69 for CAP, 1.93 for controls).
Conclusions:
- A significant proportion of elderly CAP survivors die within one year post-discharge.
- Mortality risk for CAP patients remains elevated compared to controls and the general population.
- Most deaths in CAP patients occur after hospital discharge, highlighting the need for post-discharge care.