TY - JOUR
T1 - Is pneumonia really the old man's friend? Two-year prognosis after community-acquired pneumonia
AU - Brancati, F. L.
AU - Chow, J. W.
AU - Wagener, M. M.
AU - Vacarello, S. J.
AU - Yu, V. L.
N1 - Funding Information:
We thank the medical house staff of the University of Pittsburgh for their assistance and Dr Michael J Klag for reviewing an early version of the manuscript. This work was supported in part by NIH training grants HL07024 and HL07180 (Dr Brancati).
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 1993/7/3
Y1 - 1993/7/3
N2 - 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.
AB - 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.
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U2 - 10.1016/0140-6736(93)91887-R
DO - 10.1016/0140-6736(93)91887-R
M3 - Article
C2 - 8100295
AN - SCOPUS:0027315340
SN - 0140-6736
VL - 342
SP - 30
EP - 33
JO - The Lancet
JF - The Lancet
IS - 8862
ER -