Epidemiology of patients hospitalised for pneumonia in 2011: a prospective multicentre cohort study

Abstract

This study was conducted to investigate the age dependent epidemiology of pneumonia and risk factors for mortality.The data were derived from the Austrian Pneumonia Network (APNET), comprising nine Departments for Internal Medicine with a total of 1,011 hospital beds. All inpatients diagnosed with pneumonia during 2011 were followed until discharge. Identification of microorganisms was performed according to local standard methods. Data of patients < 65 years and ≥ 65 years were compared by Mann-Whitney and the Chi-square tests. Risk factors for hospital mortality were evaluated by univariate and multivariate analyses.Overall, 1,956 patients were included. The hospital mortality was 10.4 %, and was higher in patients ≥ 65 (12.7 %) than in patients < 65 years of age (5.0 %; p < 0.001). Streptococcus (S.) pneumoniae was the most important pathogen. Enterobacteriacaeae were revealed significantly more often in patients ≥ 65 years. Age ≥ 65 years, chronic heart failure (CHF) and neurological disease increased the risk of hospital mortality 1.96 (95 % CI 1.19-3.20), 1.59 (95 % CI 1.10-2.29), and 1.7 (95 % CI 1.19-2.41)-fold, respectively.In conclusion, pneumonia patients with CHF, neurological disease and age ≥ 65 years could benefit from intensified care due to increased risk of in-hospital death.

Pneumonia Readmissions in Older Adults With Dementia

“…Patient factors that increase the risk of contracting pneumonia include (a) chronic lung diseases, (b) smoking, (c) brain disorders including dementia, (d) immune system problems, (e) other serious illnesses, and (f) recent surgery or trauma (Centers for Disease Control and Prevention, 2014; U.S. National Library of Medicine, 2014). In addition to these, risk factors for pneumonia for older adults include (a) heart disease, (b) dysphagia, and (c) institutionalization (Schmidt-Ioanas & Lode, 2006;Wenisch et al, 2013). The rate of mortality for older adults with pneumonia increases with increasing age (over 65) and with comorbidities such as congestive heart failure and neurological diseases (Wenisch et al, 2013).…”

“…In addition to these, risk factors for pneumonia for older adults include (a) heart disease, (b) dysphagia, and (c) institutionalization (Schmidt-Ioanas & Lode, 2006;Wenisch et al, 2013). The rate of mortality for older adults with pneumonia increases with increasing age (over 65) and with comorbidities such as congestive heart failure and neurological diseases (Wenisch et al, 2013).…”

“…The clinical presentation associated with pneumonia includes (a) cough, (b) fever, (c) chills, (d) shortness of breath, (e) malaise, and (f) fatigue (U.S. National Library of Medicine, 2014). However, the clinical presentation of pneumonia in older adults is often more subtle, making detection more difficult (Schmidt-Ioanas & Lode, 2006;Wenisch et al, 2013). Typical symptoms associated with pneumonia are often absent in older adults;…”

“…instead older adults with pneumonia present with altered mental status or delirium (Riquelme et al, 1997;Wenisch et al, 2013). Older adults are at an increased risk for dehydration due to pneumonia, and it is the dehydration in combination with the infection that can lead to delirium being the first symptom of pneumonia in older adults who are otherwise asymptomatic (Wenisch et al, 2013).…”

Pneumonia and Host Defense in the Elderly

“…11 Similar findings for chronic heart disease (OR, 1.59), but not COPD or diabetes, were also seen in an Austrian population. 32 In addition to the direct effects of smoking (eg, COPD, heart disease) on the incidence of pneumonia in the elderly, exposure to secondhand smoke was recently shown to increase the risk of pneumonia in the elderly by over 1.5 times. 33 Interestingly, this effect was seen only in those over the age of 65 years and was not observed in the younger cohort.…”