0
Chest Infections |

Early Mortality in Very Elderly Patients With Non-Hospital Acquired Pneumonia: Causes and Risk Factors

Jae Seok Park, MD; Yeong June Jeon, MD
Author and Funding Information

Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea


Chest. 2013;144(4_MeetingAbstracts):255A. doi:10.1378/chest.1704337
Text Size: A A A
Published online

Abstract

SESSION TITLE: Infections in Older Patients

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, October 27, 2013 at 04:15 PM - 05:15 PM

PURPOSE: Pneumonia is one of the leading causes of death in elderly. A number of risk factors may influence mortality in very elderly patients with pneumonia, and some of the factors associated with early mortality may differ from those associated with mortality occurring later. The aim of this study was to evaluate the causes and factors related with early mortality in very elderly hospitalized patients with non-hospital acquired pneumonia (NHAP).

METHODS: We performed a retrospective study of all hospital death patients ≥80 yr age admitted with diagnosis of NHAP in single center between June 2007 and May 2012. Clinical data obtained included demographic characteristics, comorbid conditions, laboratory investigation, microbiological data, chest radiographic findings, pneumonia severity index (PSI) and CURB-65 pneumonia severity score. Early deaths, defined as death due to any cause of death ≤48 h after admission, were compared with late deaths (patients who died >48 h). Univariate and multivariate regression analysis were performed to identify risk factors for early mortality.

RESULTS: A total of 76 NHAP patients were included in this study period. Twenty-one patients (27.6%) died ≤48 h after admission. Overall, mean hospital day was 12.63±22.16. The main causes of early mortality were septic shock/multiorgan failure (57.1%%). Factors associated with early mortality were bedridden status before admission, PSI class V, vasopressor at admission and nursing home care. After adjustment for covariates, we found that PSI class V (OR, 9.968; p=0.033) and nursing home care (OR, 4.461; p=0.024) were independent factors associated with early mortality.

CONCLUSIONS: This study suggests that PSI class V and nursing home care may be useful predictors of early mortality in very elderly non-hospital acquired pneumonia patients.

CLINICAL IMPLICATIONS: Identification of patients at high risk for early death may help decision for intensive care and end-of-life care in this group of patients.

DISCLOSURE: The following authors have nothing to disclose: Jae Seok Park, Yeong June Jeon

No Product/Research Disclosure Information


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543