Factors associated with 30-day mortality in elderly inpatients with community acquired pneumonia during 2 influenza seasons.
Identifieur interne : 000096 ( Main/Exploration ); précédent : 000095; suivant : 000097Factors associated with 30-day mortality in elderly inpatients with community acquired pneumonia during 2 influenza seasons.
Auteurs : Núria Torner [Espagne] ; Conchita Izquierdo [Espagne] ; Núria Soldevila [Espagne] ; Diana Toledo [Espagne] ; Judith Chamorro [Espagne] ; Elena Espejo [Espagne] ; Amelia Fernández-Sierra [Espagne] ; Angela Domínguez [Espagne]Source :
- Human vaccines & immunotherapeutics [ 2164-554X ] ; 2017.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- mortality : Community-Acquired Infections, Pneumonia.
- Aged, Aged, 80 and over, Case-Control Studies, Female, Hospitalization, Humans, Male, Spain, Survival Analysis.
Abstract
Community-acquired pneumonia (CAP) refers to pneumonia unrelated to hospitals or extended-care facilities. The aim of this study was to determine factors associated with 30-day mortality in patients with CAP aged ≥ 65 y admitted to 20 hospitals in 7 Spanish regions during the 2013-14 and 2014-15 influenza seasons. Logistic regression was used to identify factors associated with 30-day mortality. The adjusted model included variables selected by backward elimination with a cut off of < 0.02. A total of 1928 CAP cases were recorded; 60.7% were male, 46.67% were aged 75-84 years, and 30-day mortality was 7.6% (n = 146). Pneumococcal vaccination had a significant protective effect (OR 0.68, 95% CI, 0.48-0.96; p = 0.03) and influenza vaccination in any 3 preceding seasons slight protective effect against CAP (OR 0.72, 95% CI, 0.51-1.02;p = 0.06). Factors significantly associated with 30-day mortality were having a degree of dependence (aOR 3.67, 95% CI, 2.34-5.75; p < 0,001); age ≥ 85 y (OR 3.01, 95% CI, 1.71-5.30; p < 0.001), liver impairment (aOR 2.41, 95% CI, 1.10-5.31; p = 0.03); solid organ neoplasm (aOR 2.24, 95% CI, 1.46-3.45; p < 0.001), impaired cognitive function (aOR 1.93, 95% CI, 1.22-3.05; p = 0.005), and ICU admittance (aOR2.56, 95% CI, 1.27-5.16; p = 0.009); length of stay (aOR 1.56, 95% CI, 1.02 - 2.40; p = 0.04) and cardio-respiratory resuscitation (aOR 7.75, 95% CI, 1.20 - 49.98; p = 0.03). No association was observed for other comorbidities such as chronic pulmonary obstructive disease (COPD) or heart conditions in the adjusted model. Offering both pneumococcal and influenza vaccination to the elderly may improve 30-day mortality in patients with CAP.
DOI: 10.1080/21645515.2017.1264782
PubMed: 27924681
PubMed Central: PMC5328220
Affiliations:
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Complejo Hospitalario Universitario , Granada , Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>f Preventive Medicine and Public Health. Complejo Hospitalario Universitario , Granada </wicri:regionArea><wicri:noRegion>Granada </wicri:noRegion></affiliation></author><author><name sortKey="Dominguez, Angela" sort="Dominguez, Angela" uniqKey="Dominguez A" first="Angela" last="Domínguez">Angela Domínguez</name><affiliation wicri:level="1"><nlm:affiliation>a CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute , Madrid , Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>a CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute , Madrid </wicri:regionArea><wicri:noRegion>Madrid </wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>b Department of Medicine. Public Health Unit , University of Barcelona , Barcelona , Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>b Department of Medicine. 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Public Health Unit , University of Barcelona , Barcelona , Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>b Department of Medicine. Public Health Unit , University of Barcelona , Barcelona </wicri:regionArea><wicri:noRegion>Barcelona </wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>c Public Health Agency of Catalonia. Generalitat of Catalonia , Barcelona , Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>c Public Health Agency of Catalonia. Generalitat of Catalonia , Barcelona </wicri:regionArea><wicri:noRegion>Barcelona </wicri:noRegion></affiliation></author><author><name sortKey="Izquierdo, Conchita" sort="Izquierdo, Conchita" uniqKey="Izquierdo C" first="Conchita" last="Izquierdo">Conchita Izquierdo</name><affiliation wicri:level="1"><nlm:affiliation>c Public Health Agency of Catalonia. Generalitat of Catalonia , Barcelona , Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>c Public Health Agency of Catalonia. Generalitat of Catalonia , Barcelona </wicri:regionArea><wicri:noRegion>Barcelona </wicri:noRegion></affiliation></author><author><name sortKey="Soldevila, Nuria" sort="Soldevila, Nuria" uniqKey="Soldevila N" first="Núria" last="Soldevila">Núria Soldevila</name><affiliation wicri:level="1"><nlm:affiliation>a CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute , Madrid , Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>a CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute , Madrid </wicri:regionArea><wicri:noRegion>Madrid </wicri:noRegion></affiliation></author><author><name sortKey="Toledo, Diana" sort="Toledo, Diana" uniqKey="Toledo D" first="Diana" last="Toledo">Diana Toledo</name><affiliation wicri:level="1"><nlm:affiliation>a CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute , Madrid , Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>a CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute , Madrid </wicri:regionArea><wicri:noRegion>Madrid </wicri:noRegion></affiliation></author><author><name sortKey="Chamorro, Judith" sort="Chamorro, Judith" uniqKey="Chamorro J" first="Judith" last="Chamorro">Judith Chamorro</name><affiliation wicri:level="1"><nlm:affiliation>d Preventive Medicine Service, Complejo Hospitalario de Navarra , Pamplona , Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>d Preventive Medicine Service, Complejo Hospitalario de Navarra , Pamplona </wicri:regionArea><wicri:noRegion>Pamplona </wicri:noRegion></affiliation></author><author><name sortKey="Espejo, Elena" sort="Espejo, Elena" uniqKey="Espejo E" first="Elena" last="Espejo">Elena Espejo</name><affiliation wicri:level="1"><nlm:affiliation>e Health Consortium of Terrassa , Terrassa , Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>e Health Consortium of Terrassa , Terrassa </wicri:regionArea><wicri:noRegion>Terrassa </wicri:noRegion></affiliation></author><author><name sortKey="Fernandez Sierra, Amelia" sort="Fernandez Sierra, Amelia" uniqKey="Fernandez Sierra A" first="Amelia" last="Fernández-Sierra">Amelia Fernández-Sierra</name><affiliation wicri:level="1"><nlm:affiliation>f Preventive Medicine and Public Health. Complejo Hospitalario Universitario , Granada , Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>f Preventive Medicine and Public Health. Complejo Hospitalario Universitario , Granada </wicri:regionArea><wicri:noRegion>Granada </wicri:noRegion></affiliation></author><author><name sortKey="Dominguez, Angela" sort="Dominguez, Angela" uniqKey="Dominguez A" first="Angela" last="Domínguez">Angela Domínguez</name><affiliation wicri:level="1"><nlm:affiliation>a CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute , Madrid , Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>a CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute , Madrid </wicri:regionArea><wicri:noRegion>Madrid </wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>b Department of Medicine. Public Health Unit , University of Barcelona , Barcelona , Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>b Department of Medicine. Public Health Unit , University of Barcelona , Barcelona </wicri:regionArea><wicri:noRegion>Barcelona </wicri:noRegion></affiliation></author></analytic><series><title level="j">Human vaccines & immunotherapeutics</title><idno type="eISSN">2164-554X</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Case-Control Studies (MeSH)</term><term>Community-Acquired Infections (mortality)</term><term>Female (MeSH)</term><term>Hospitalization (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Pneumonia (mortality)</term><term>Spain (MeSH)</term><term>Survival Analysis (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Analyse de survie (MeSH)</term><term>Espagne (MeSH)</term><term>Femelle (MeSH)</term><term>Hospitalisation (MeSH)</term><term>Humains (MeSH)</term><term>Infections communautaires (mortalité)</term><term>Mâle (MeSH)</term><term>Pneumopathie infectieuse (mortalité)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Études cas-témoins (MeSH)</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Community-Acquired Infections</term><term>Pneumonia</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Infections communautaires</term><term>Pneumopathie infectieuse</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Case-Control Studies</term><term>Female</term><term>Hospitalization</term><term>Humans</term><term>Male</term><term>Spain</term><term>Survival Analysis</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Analyse de survie</term><term>Espagne</term><term>Femelle</term><term>Hospitalisation</term><term>Humains</term><term>Mâle</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Études cas-témoins</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Community-acquired pneumonia (CAP) refers to pneumonia unrelated to hospitals or extended-care facilities. The aim of this study was to determine factors associated with 30-day mortality in patients with CAP aged ≥ 65 y admitted to 20 hospitals in 7 Spanish regions during the 2013-14 and 2014-15 influenza seasons. Logistic regression was used to identify factors associated with 30-day mortality. The adjusted model included variables selected by backward elimination with a cut off of < 0.02. A total of 1928 CAP cases were recorded; 60.7% were male, 46.67% were aged 75-84 years, and 30-day mortality was 7.6% (n = 146). Pneumococcal vaccination had a significant protective effect (OR 0.68, 95% CI, 0.48-0.96; p = 0.03) and influenza vaccination in any 3 preceding seasons slight protective effect against CAP (OR 0.72, 95% CI, 0.51-1.02;p = 0.06). Factors significantly associated with 30-day mortality were having a degree of dependence (aOR 3.67, 95% CI, 2.34-5.75; p < 0,001); age ≥ 85 y (OR 3.01, 95% CI, 1.71-5.30; p < 0.001), liver impairment (aOR 2.41, 95% CI, 1.10-5.31; p = 0.03); solid organ neoplasm (aOR 2.24, 95% CI, 1.46-3.45; p < 0.001), impaired cognitive function (aOR 1.93, 95% CI, 1.22-3.05; p = 0.005), and ICU admittance (aOR2.56, 95% CI, 1.27-5.16; p = 0.009); length of stay (aOR 1.56, 95% CI, 1.02 - 2.40; p = 0.04) and cardio-respiratory resuscitation (aOR 7.75, 95% CI, 1.20 - 49.98; p = 0.03). No association was observed for other comorbidities such as chronic pulmonary obstructive disease (COPD) or heart conditions in the adjusted model. Offering both pneumococcal and influenza vaccination to the elderly may improve 30-day mortality in patients with CAP.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">27924681</PMID><DateCompleted><Year>2017</Year><Month>10</Month><Day>23</Day></DateCompleted><DateRevised><Year>2018</Year><Month>11</Month><Day>13</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2164-554X</ISSN><JournalIssue CitedMedium="Internet"><Volume>13</Volume><Issue>2</Issue><PubDate><Year>2017</Year><Month>02</Month></PubDate></JournalIssue><Title>Human vaccines & immunotherapeutics</Title><ISOAbbreviation>Hum Vaccin Immunother</ISOAbbreviation></Journal><ArticleTitle>Factors associated with 30-day mortality in elderly inpatients with community acquired pneumonia during 2 influenza seasons.</ArticleTitle><Pagination><MedlinePgn>450-455</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1080/21645515.2017.1264782</ELocationID><Abstract><AbstractText>Community-acquired pneumonia (CAP) refers to pneumonia unrelated to hospitals or extended-care facilities. The aim of this study was to determine factors associated with 30-day mortality in patients with CAP aged ≥ 65 y admitted to 20 hospitals in 7 Spanish regions during the 2013-14 and 2014-15 influenza seasons. Logistic regression was used to identify factors associated with 30-day mortality. The adjusted model included variables selected by backward elimination with a cut off of < 0.02. A total of 1928 CAP cases were recorded; 60.7% were male, 46.67% were aged 75-84 years, and 30-day mortality was 7.6% (n = 146). Pneumococcal vaccination had a significant protective effect (OR 0.68, 95% CI, 0.48-0.96; p = 0.03) and influenza vaccination in any 3 preceding seasons slight protective effect against CAP (OR 0.72, 95% CI, 0.51-1.02;p = 0.06). Factors significantly associated with 30-day mortality were having a degree of dependence (aOR 3.67, 95% CI, 2.34-5.75; p < 0,001); age ≥ 85 y (OR 3.01, 95% CI, 1.71-5.30; p < 0.001), liver impairment (aOR 2.41, 95% CI, 1.10-5.31; p = 0.03); solid organ neoplasm (aOR 2.24, 95% CI, 1.46-3.45; p < 0.001), impaired cognitive function (aOR 1.93, 95% CI, 1.22-3.05; p = 0.005), and ICU admittance (aOR2.56, 95% CI, 1.27-5.16; p = 0.009); length of stay (aOR 1.56, 95% CI, 1.02 - 2.40; p = 0.04) and cardio-respiratory resuscitation (aOR 7.75, 95% CI, 1.20 - 49.98; p = 0.03). No association was observed for other comorbidities such as chronic pulmonary obstructive disease (COPD) or heart conditions in the adjusted model. Offering both pneumococcal and influenza vaccination to the elderly may improve 30-day mortality in patients with CAP.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Torner</LastName><ForeName>Núria</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>a CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute , Madrid , Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>b Department of Medicine. Public Health Unit , University of Barcelona , Barcelona , Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>c Public Health Agency of Catalonia. Generalitat of Catalonia , Barcelona , Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Izquierdo</LastName><ForeName>Conchita</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>c Public Health Agency of Catalonia. Generalitat of Catalonia , Barcelona , Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Soldevila</LastName><ForeName>Núria</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>a CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute , Madrid , Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Toledo</LastName><ForeName>Diana</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>a CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute , Madrid , Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chamorro</LastName><ForeName>Judith</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>d Preventive Medicine Service, Complejo Hospitalario de Navarra , Pamplona , Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Espejo</LastName><ForeName>Elena</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>e Health Consortium of Terrassa , Terrassa , Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fernández-Sierra</LastName><ForeName>Amelia</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>f Preventive Medicine and Public Health. Complejo Hospitalario Universitario , Granada , Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Domínguez</LastName><ForeName>Angela</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>a CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute , Madrid , Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>b Department of Medicine. Public Health Unit , University of Barcelona , Barcelona , Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>Project PI12/02079 Working Group</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>12</Month><Day>07</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Hum Vaccin Immunother</MedlineTA><NlmUniqueID>101572652</NlmUniqueID><ISSNLinking>2164-5515</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016022" MajorTopicYN="N">Case-Control Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017714" MajorTopicYN="N">Community-Acquired Infections</DescriptorName><QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006760" MajorTopicYN="N">Hospitalization</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011014" MajorTopicYN="N">Pneumonia</DescriptorName><QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013030" MajorTopicYN="N">Spain</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016019" MajorTopicYN="N">Survival Analysis</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">aging</Keyword><Keyword MajorTopicYN="Y">community acquired pneumonia</Keyword><Keyword MajorTopicYN="Y">elderly</Keyword><Keyword MajorTopicYN="Y">mortality</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>12</Month><Day>8</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>10</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>12</Month><Day>8</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">27924681</ArticleId><ArticleId 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