help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Online Data Supplement
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by KAPLAN, V.
Right arrow Articles by LINDE-ZWIRBLE, W. T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by KAPLAN, V.
Right arrow Articles by LINDE-ZWIRBLE, W. T.

Am. J. Respir. Crit. Care Med., Volume 165, Number 6, March 2002, 766-772

Hospitalized Community-acquired Pneumonia in the Elderly
Age- and Sex-related Patterns of Care and Outcome in the United States

VLADIMIR KAPLAN, DEREK C. ANGUS, MARTIN F. GRIFFIN, GILLES CLERMONT, R. SCOTT WATSON, and WALTER T. LINDE-ZWIRBLE

Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Laboratory, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh; and Health Process Management, Inc., Doylestown, PA

Community-acquired pneumonia (CAP) is a frequent cause of hospital admission and death among elderly patients, but there is little information on age- and sex-specific incidence, patterns of care (intensive care unit admission and mechanical ventilation), resource use (length of stay and hospital costs), and outcome (mortality). We conducted an observational cohort study of all Medicare recipients, aged 65 years or older, hospitalized in nonfederal U.S. hospitals in 1997, who met ICD-9-CM-based criteria for CAP. We identified 623,718 hospital admissions for CAP (18.3 per 1,000 population >=  65 years), of which 26,476 (4.3%) were from nursing homes and of which 66,045 (10.6%) died. The incidence rose five-fold and mortality doubled as age increased from 65-69 to older than 90 years. Men had a higher mortality, both unadjusted (odds ratio [OR]: 1.21 [95% CI: 1.19-1.23]) and adjusted for age, location before admission, underlying comorbidity, and microbiologic etiology (OR: 1.15 [95% CI: 1.13-1.17]). Mean hospital length of stay and costs per hospital admission were 7.6 days and $6,949. For those admitted to the intensive care unit (22.4%) and for those receiving mechanical ventilation (7.2%), mean length of stay and costs were 11.3 days and $14,294, and 15.7 days and $23,961, respectively. Overall hospital costs were $4.4 billion (6.3% of the expenditure in the elderly for acute hospital care), of which $2.1 billion was incurred by cases managed in intensive care units. We conclude that in the hospitalized elderly, CAP is a common and frequently fatal disease that often requires intensive care unit admission and mechanical ventilation and consumes considerable health care resources. The sex differences are of concern and require further investigation.




This article has been cited by other articles:


Home page
 Age AgeingHome page
M. Cabre, M. Serra-Prat, E. Palomera, J. Almirall, R. Pallares, and P. Clave
Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia
Age Ageing, January 1, 2010; 39(1): 39 - 45.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
A. Torres and R. Menendez
Meeting the old man's friend
Thorax, December 1, 2009; 64(12): 1016 - 1017.
[Full Text] [PDF]

Home page
 ThoraxHome page
S Ewig, N Birkner, R Strauss, E Schaefer, J Pauletzki, H Bischoff, P Schraeder, T Welte, and G Hoeffken
New perspectives on community-acquired pneumonia in 388 406 patients. Results from a nationwide mandatory performance measurement programme in healthcare quality
Thorax, December 1, 2009; 64(12): 1062 - 1069.
[Abstract] [Full Text] [PDF]

Home page
 Arch Intern MedHome page
C. McCabe, C. Kirchner, H. Zhang, J. Daley, and D. N. Fisman
Guideline-Concordant Therapy and Reduced Mortality and Length of Stay in Adults With Community-Acquired Pneumonia: Playing by the Rules
Arch Intern Med, September 14, 2009; 169(16): 1525 - 1531.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Clin. Nutr.Home page
I. Watanabe, S. Kuriyama, M. Kakizaki, T. Sone, K. Ohmori-Matsuda, N. Nakaya, A. Hozawa, and I. Tsuji
Green tea and death from pneumonia in Japan: the Ohsaki cohort study
Am. J. Clinical Nutrition, September 1, 2009; 90(3): 672 - 679.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
R Menendez, R Martinez, S Reyes, J Mensa, X Filella, M A Marcos, A Martinez, C Esquinas, P Ramirez, and A Torres
Biomarkers improve mortality prediction by prognostic scales in community-acquired pneumonia
Thorax, July 1, 2009; 64(7): 587 - 591.
[Abstract] [Full Text] [PDF]

Home page
 QJMHome page
A. Singanayagam, J.D. Chalmers, and A.T. Hill
Severity assessment in community-acquired pneumonia: a review
QJM, June 1, 2009; 102(6): 379 - 388.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
A Capelastegui, P P Espana, J M Quintana, A Bilbao, R Menendez, R Zalacain, and A Torres
Development of a prognostic index for 90-day mortality in patients discharged after admission to hospital for community-acquired pneumonia
Thorax, June 1, 2009; 64(6): 496 - 501.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
H. Kothe, T. Bauer, R. Marre, N. Suttorp, T. Welte, K. Dalhoff, and the Competence Network for Community-Acquired Pneu
Outcome of community-acquired pneumonia: influence of age, residence status and antimicrobial treatment
Eur. Respir. J., July 1, 2008; 32(1): 139 - 146.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
S. Reyes, R. Martinez, J. M. Valles, E. Cases, and R. Menendez
Determinants of hospital costs in community-acquired pneumonia
Eur. Respir. J., May 1, 2008; 31(5): 1061 - 1067.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
R Menendez, M Cavalcanti, S Reyes, J Mensa, R Martinez, M A Marcos, X Filella, M Niederman, and A Torres
Markers of treatment failure in hospitalised community acquired pneumonia
Thorax, May 1, 2008; 63(5): 447 - 452.
[Abstract] [Full Text] [PDF]

Home page
 Nephrol Dial TransplantHome page
H. Guo, J. Liu, A. J. Collins, and R. N. Foley
Pneumonia in incident dialysis patients--the United States Renal Data System
Nephrol. Dial. Transplant., February 1, 2008; 23(2): 680 - 686.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
J. B. Kornum, R. W. Thomsen, A. Riis, H.-H. Lervang, H. C. Schonheyder, and H. T. Sorensen
Type 2 Diabetes and Pneumonia Outcomes: A population-based cohort study
Diabetes Care, September 1, 2007; 30(9): 2251 - 2257.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. Valencia, J. R. Badia, M. Cavalcanti, M. Ferrer, C. Agusti, J. Angrill, E. Garcia, J. Mensa, M. S. Niederman, and A. Torres
Pneumonia Severity Index Class V Patients With Community-Acquired Pneumonia: Characteristics, Outcomes, and Value of Severity Scores
Chest, August 1, 2007; 132(2): 515 - 522.
[Abstract] [Full Text] [PDF]

Home page
 Age AgeingHome page
T. Pepersack and S. de Breucker
Could geriatric comprehensive assessment predict the outcome of pneumonia in the very old?
Age Ageing, July 1, 2007; 36(4): 455 - 459.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
R. Menendez, S. Reyes, R. Martinez, P. de la Cuadra, J. Manuel Valles, and J. Vallterra
Economic evaluation of adherence to treatment guidelines in nonintensive care pneumonia
Eur. Respir. J., April 1, 2007; 29(4): 751 - 756.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
P. P. Espana, A. Capelastegui, I. Gorordo, C. Esteban, M. Oribe, M. Ortega, A. Bilbao, and J. M. Quintana
Development and Validation of a Clinical Prediction Rule for Severe Community-acquired Pneumonia
Am. J. Respir. Crit. Care Med., December 1, 2006; 174(11): 1249 - 1256.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
A. F. Shorr, M. Bodi, A. Rodriguez, J. Sole-Violan, J. Garnacho-Montero, J. Rello, and for the CAPUCI Study Investigators
Impact of antibiotic guideline compliance on duration of mechanical ventilation in critically ill patients with community-acquired pneumonia.
Chest, July 1, 2006; 130(1): 93 - 100.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. Christ-Crain, D. Stolz, R. Bingisser, C. Muller, D. Miedinger, P. R. Huber, W. Zimmerli, S. Harbarth, M. Tamm, and B. Muller
Procalcitonin Guidance of Antibiotic Therapy in Community-acquired Pneumonia: A Randomized Trial
Am. J. Respir. Crit. Care Med., July 1, 2006; 174(1): 84 - 93.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
T. Dremsizov, G. Clermont, J. A. Kellum, K. G. Kalassian, M. J. Fine, and D. C. Angus
Severe sepsis in community-acquired pneumonia: when does it happen, and do systemic inflammatory response syndrome criteria help predict course?
Chest, April 1, 2006; 129(4): 968 - 978.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
M. S. Niederman, C. Feldman, and G. A. Richards
Combining information from prognostic scoring tools for CAP: an American view on how to get the best of all worlds.
Eur. Respir. J., January 1, 2006; 27(1): 9 - 11.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
A. Capelastegui, P. P. Espana, J. M. Quintana, I. Areitio, I. Gorordo, M. Egurrola, and A. Bilbao
Validation of a predictive rule for the management of community-acquired pneumonia
Eur. Respir. J., January 1, 2006; 27(1): 151 - 157.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
A. M. Fry, D. K. Shay, R. C. Holman, A. T. Curns, and L. J. Anderson
Trends in Hospitalizations for Pneumonia Among Persons Aged 65 Years or Older in the United States, 1988-2002
JAMA, December 7, 2005; 294(21): 2712 - 2719.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
T. M. File Jr and J. S. Tan
Pneumonia in Older Adults: Reversing the Trend
JAMA, December 7, 2005; 294(21): 2760 - 2763.
[Full Text] [PDF]

Home page
 American Journal of Medical QualityHome page
D. Aronsky, P. J. Haug, C. Lagor, and N. C. Dean
Accuracy of Administrative Data for Identifying Patients With Pneumonia
American Journal of Medical Quality, November 1, 2005; 20(6): 319 - 328.
[Abstract] [PDF]

Home page
 ChestHome page
E. B. Milbrandt and D. C. Angus
What's in a Day?
Chest, November 1, 2005; 128(5): 3091 - 3093.
[Full Text] [PDF]

Home page
 CMAJHome page
E. P. Rivers, L. McIntyre, D. C. Morro, and K. K. Rivers
Early and innovative interventions for severe sepsis and septic shock: taking advantage of a window of opportunity
Can. Med. Assoc. J., October 25, 2005; 173(9): 1054 - 1065.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. Menendez, A. Torres, R. Zalacain, J. Aspa, J. J. Martin-Villasclaras, L. Borderias, J. M. Benitez-Moya, J. Ruiz-Manzano, F. R. de Castro, J. Blanquer, et al.
Guidelines for the Treatment of Community-acquired Pneumonia: Predictors of Adherence and Outcome
Am. J. Respir. Crit. Care Med., September 15, 2005; 172(6): 757 - 762.
[Abstract] [Full Text] [PDF]

Home page
 Arch Otolaryngol Head Neck SurgHome page
B. Martin-Harris, M. B. Brodsky, Y. Michel, C. L. Ford, B. Walters, and J. Heffner
Breathing and Swallowing Dynamics Across the Adult Lifespan
Arch Otolaryngol Head Neck Surg, September 1, 2005; 131(9): 762 - 770.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
N. N. Hansel, B. Merriman, E. F. Haponik, and G. B. Diette
Hospitalizations for Tuberculosis in the United States in 2000: Predictors of In-Hospital Mortality
Chest, October 1, 2004; 126(4): 1079 - 1086.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
G. L. Colice, M. A. Morley, C. Asche, and H. G. Birnbaum
Treatment Costs of Community-Acquired Pneumonia in an Employed Population
Chest, June 1, 2004; 125(6): 2140 - 2145.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
T. Ohkubo, N. Chapman, B. Neal, M. Woodward, T. Omae, and J. Chalmers
Effects of an Angiotensin-converting Enzyme Inhibitor-based Regimen on Pneumonia Risk
Am. J. Respir. Crit. Care Med., May 1, 2004; 169(9): 1041 - 1045.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
K. Yamazaki, S. Ogura, A. Ishizaka, T. Oh-hara, and M. Nishimura
Bronchoscopic Microsampling Method for Measuring Drug Concentration in Epithelial Lining Fluid
Am. J. Respir. Crit. Care Med., December 1, 2003; 168(11): 1304 - 1307.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
P. E. Marik and D. Kaplan
Aspiration Pneumonia and Dysphagia in the Elderly
Chest, July 1, 2003; 124(1): 328 - 336.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
L. A. Jackson, K. M. Neuzil, O. Yu, P. Benson, W. E. Barlow, A. L. Adams, C. A. Hanson, L. D. Mahoney, D. K. Shay, W. W. Thompson, et al.
Effectiveness of Pneumococcal Polysaccharide Vaccine in Older Adults
N. Engl. J. Med., May 1, 2003; 348(18): 1747 - 1755.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. Metersky, D. C. Angus, and W. T. Linde-Zwirble
Estimated frequency of nursing facility-acquired pneumonia?
Am. J. Respir. Crit. Care Med., May 1, 2003; 167(9): 1287 - 1288.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
R. Zalacain, A. Torres, R. Celis, J. Blanquer, J. Aspa, L. Esteban, R. Menendez, R. Blanquer, and L. Borderias
Community-acquired pneumonia in the elderly: Spanish multicentre study
Eur. Respir. J., February 1, 2003; 21(2): 294 - 302.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. Tobin
Critical Care Medicine in AJRCCM 2002
Am. J. Respir. Crit. Care Med., February 1, 2003; 167(3): 294 - 305.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. Tobin
Tuberculosis, Lung Infections, Interstitial Lung Disease, and Journalology in AJRCCM 2002
Am. J. Respir. Crit. Care Med., February 1, 2003; 167(3): 345 - 355.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2002 American Thoracic Society 		  2nd Annual Dinner