This Article Full Text Full Text (PDF) All Versions of this Article: 200310-1448OCv1 169/8/910    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Waterer, G. W. Articles by Wunderink, R. G. Search for Related Content PubMed PubMed Citation Articles by Waterer, G. W. Articles by Wunderink, R. G.

Medium-Term Survival after Hospitalization with Community-Acquired Pneumonia

Department of Medicine, University of Western Australia, and Department of Respiratory Medicine, Royal Perth Hospital, Perth, Western Australia, Australia; and Physicians Research Network, Methodist Le Bonheur Healthcare, and Clinical Research, Methodist Healthcare, Memphis, Tennessee

Correspondence and requests for reprints should be addressed to Grant W. Waterer, M.B.B.S., F.R.A.C.P., School of Medicine and Pharmacology, University of Western Australia, and Department of Respiratory Medicine, Royal Perth Hospital, G.P.O. Box X2213, Perth 6847, Western Australia, Australia. E-mail: waterer{at}cyllene.uwa.edu.au

An episode of community-acquired pneumonia (CAP) has been suggested to predict greater than expected mortality after discharge from hospital. We ascertained the survival status as of December 2002 of a cohort of patients with CAP identified prospectively between November 1998 and June 2001. Cox regression analysis was used to examine the impact of demographic factors, comorbid illnesses, and CAP severity on subsequent mortality. Of 378 CAP survivors we ascertained the survival status of 366 (96.9%), 125 (34.1%) of whom had died. The mean length of follow-up was 1,058 days (range, 602–1,500 days). Independent predictors of mortality were increasing age (p < 0.001), comorbid cerebrovascular (p = 0.002) and cardiovascular (p = 0.023) disease, an altered mental state (p < 0.001), a hematocrit of less than 35% (p = 0.035), and increasing blood glucose level (p = 0.025). In 41- to 80-year-olds without significant comorbidities there was a trend to greater than expected mortality. In conclusion, an episode of CAP in young adults without significant comorbid illnesses does not appear to be an adverse prognostic marker of medium-term survival. The trend to greater than expected mortality in patients over 40 years of age needs further study and physicians should be particularly alert for underlying life-limiting disease processes in patients presenting with acute confusion or a hematocrit of less than 35%.

Key Words: hospitalization • pneumonia, survival long-term

This article has been cited by other articles:

				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]

				R. F. Grossman Community-Acquired Pneumonia: Advances in Management ACCP Pulmonary Med Brd Rev, January 1, 2009; 25(0): 359 - 368. [Full Text] [PDF]

				S. Yende, G. D'Angelo, J. A. Kellum, L. Weissfeld, J. Fine, R. D. Welch, L. Kong, M. Carter, D. C. Angus, and for the GenIMS Investigators Inflammatory Markers at Hospital Discharge Predict Subsequent Mortality after Pneumonia and Sepsis Am. J. Respir. Crit. Care Med., June 1, 2008; 177(11): 1242 - 1247. [Abstract] [Full Text] [PDF]

				G. W. Waterer, L. A. Kessler, and R. G. Wunderink Delayed administration of antibiotics and atypical presentation in community-acquired pneumonia. Chest, July 1, 2006; 130(1): 11 - 15. [Abstract] [Full Text] [PDF]

				J. Rello, A. Rodriguez, A. Torres, J. Roig, J. Sole-Violan, J. Garnacho-Montero, M. V. de la Torre, J. M. Sirvent, M. Bodi, and for the CAPUCI study investigators Implications of COPD in patients admitted to the intensive care unit by community-acquired pneumonia Eur. Respir. J., June 1, 2006; 27(6): 1210 - 1216. [Abstract] [Full Text] [PDF]

				D. Angus, A. Ishizaka, M. Matthay, F. Lemaire, W. MacNee, and E. Abraham Critical Care in AJRCCM 2004 Am. J. Respir. Crit. Care Med., March 15, 2005; 171(6): 537 - 544. [Full Text] [PDF]

				J. E. Heffner Multicenter Trials of Treatment for Empyema -- After All These Years N. Engl. J. Med., March 3, 2005; 352(9): 926 - 928. [Full Text] [PDF]

				S. F. Dowell Surviving Pneumonia--Just a Short-Term Lease on Life? Am. J. Respir. Crit. Care Med., April 15, 2004; 169(8): 895 - 896. [Full Text] [PDF]