Predictors of 30-day mortality in elderly patients with community acquired pneumonia

Abstract

Background: Community acquired pneumonia (CAP) is an important cause for death in the elderly. We aimed to determine the predictors of 30-day mortality in elderly patients with CAP. Methods: This retrospective cohort study was performed in a tertiary-care university hospital. A total of 393 consecutive patients with age ≥65 years who were immunocompetent and hospitalized due to CAP during a 24-month period were enrolled. Clinical characteristics and laboratory data were collected. Logistic regression analysis was used to determine the independent predictors of 30-day mortality. Results: The mean age was 76.0 ± 7.0 years (range 65–98 years), and 61.3% of the patients were male. The mean length of hospital stay was 14.3 ± 11.8 days. Intensive care unit admission rate was 5.1%. The 30-day mortality was 7.4%, and hospital mortality was 9.2%. In multivariate analysis, independent predictors of 30-day mortality in elderly patients with CAP were: requirement for invasive mechanical ventilation (OR 46.7, p = 0.000, 95% CI 10.2-213.6), altered mental status (OR 11.2, p = 0.000, 95% CI 3.7-33.5), congestive heart failure (OR 7.8, p = 0.000, 95% CI 2.5-24.8), and chronic renal insufficiency (OR 5.2, p = 0.001, 95% CI 2.0 -13.8). Conclusions: In this cohort of elderly patients with CAP, requirement for invasive mechanical ventilation, altered mental status, congestive heart failure, and chronic renal insufficiency were independent predictors of 30-day mortality. Our findings suggest that both pneumonia severity and comorbidities might predict 30-day mortality in elderly patients hospitalized with CAP.