Published ahead of print on December 23, 2003, doi:10.1164/rccm.200310-1448OC Am. J. Respir. Crit. Care Med., Volume 169, Number 8, April 2004, 910-914 A more recent version of this article appeared on April 15, 2004
Submitted on October 24, 2003 Medium-term survival after hospitalization with community-acquired pneumoniaGrant W Waterer1*,1 Medicine, University of Western Australia, Perth, Australia, 2 Clinical Research, Methodist Le Boneheur Healthcare, Memphis, TN, USA * To whom correspondence should be addressed. 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 1058 days (range 602-1500). 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 <35% (p=0.035) and increasing blood glucose level (p=0.025). In 41-80 year olds without significant comorbiditities 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<35%. Key words: pneumonia, survival, long-term, hospitalization
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