Predictors of Long-term Outcomes in the Older Adults with Community-Acquired Pneumonia

  • Serkan Surme Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
  • Ilker Inanc Balkan Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
  • Osman Faruk Bayramlar Department of Public Health, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
  • Ritvan Kara Ali Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
  • Bilgul Mete Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
  • Fehmi Tabak Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
  • Nese Saltoğlu Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
Keywords: community-acquired pneumonia, long-term mortality, intensive care, mechanical ventilation, hospital readmission

Abstract

Introduction: 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.

Author Biographies

Ilker Inanc Balkan, Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey

Department of Infectious Disease and Clinical Microbiology. Assoc. Prof.

Osman Faruk Bayramlar, Department of Public Health, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey

Department of Public Health. MD.

Ritvan Kara Ali, Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey

Department of Infectious Disease and Clinical Microbiology. Assist. Prof.

Bilgul Mete, Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey

Department of Infectious Disease and Clinical Microbiology

Fehmi Tabak, Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey

Department of Infectious Disease and Clinical Microbiology. Prof.

Nese Saltoğlu, Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey

Department of Infectious Disease and Clinical Microbiology, Prof.

Published
2021-12-31
How to Cite
1.
Surme S, Balkan II, Bayramlar OF, Kara AliR, Mete B, Tabak F, Saltoğlu N (2021) Predictors of Long-term Outcomes in the Older Adults with Community-Acquired Pneumonia. J Infect Dev Ctries 15:1910-1916. doi: 10.3855/jidc.14881
Section
Original Articles