Is pneumonia really the old man's friend? Two-year prognosis after community-acquired pneumonia

F. L. Brancati, J. W. Chow, M. M. Wagener, S. J. Vacarello, V. L. Yu

Research output: Contribution to journalArticlepeer-review

Abstract

SummaryIs pneumonia "the old man's friend"-a terminal event for patients who will otherwise die soon of underlying chronic disease? If so, chronological age might influence treatment policy. We investigated the predictors of 2-year mortality after patients' admission to hospital for community-acquired pneumonia, and focused on the predictive value of age. In a prospective cohort study 141 consecutive patients were admitted to hospital with community-acquired pneumonia. Clinical, laboratory, and sociodemographic data were collected on admission. Comorbidity was categorised as mild, moderate, or severe by a physician based on the patient's medical history. Survival was assessed at 24 months after discharge. 22 (16%) patients died in hospital. Of the remaining 119, 38 (32%) died over the next 24 months. In a Cox model, 2-year mortality was independently related to severe comorbidity (relative risk [RR]=9·4) or moderate comorbidity (RR=3·1), and to haematocrit less than 35% (RR=2·9) (all p≤0·005). However, compared with patients aged 18-44 years, patients aged 45-64 (RR=0·84), 65-74 (RR=1·28), and 75-92 (RR=1·99) were not significantly more likely to die during the 24 months after discharge (all p≥0·2). Old age should not be a sole criterion for withholding aggressive treatment of community-acquired pneumonia.

Original languageEnglish (US)
Pages (from-to)30-33
Number of pages4
JournalThe Lancet
Volume342
Issue number8862
DOIs
StatePublished - Jul 3 1993

ASJC Scopus subject areas

  • Medicine(all)

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