Long Term Mortality in Community-Acquired Pneumonia: Incidence In Special Populations

Abstract

Introduction Community-acquired pneumonia (CAP) has increased recognition for long-term mortality after acute infection. In this study, we reviewed our prior work with the objective to define the incidence in long-term mortality in special populations of patients hospitalized with CAP. Methods This study was a secondary analysis of two study databases for patients hospitalized in Louisville, KY. Long-term mortality was defined as all-cause mortality within one year of hospitalization, and was evaluated for the following groups: adults hospitalized without CAP, adults hospitalized with CAP, adults hospitalized with CAP for special populations. Long term mortality was also evaluated at the census tract level and geospatial epidemiology was performed to identify areas of risk within Louisville. Results Long-term mortality for adults hospitalized without CAP was 19.5%. For adults hospitalized with CAP, long-term mortality was 29.8% to 31.7%, depending on study database. For special populations, patients with CAP needing ICU care, patients with CAP experiencing cardiovascular events during hospitalization, and immunocompromised patients with CAP had the highest long term mortality, at 46.6%, 48.6%, and 53.6%, respectively. Geospatial epidemiology found no areas at increased risk for long term mortality. Conclusions Patients hospitalized with CAP have higher long-term mortality than patients hospitalized due to other reasons. Long-term mortality concentrates in special populations of hospitalized patients with CAP. These populations should take priority in future research studies evaluating pathogenesis and prevention strategies.