Marked Reduction in 30-Day Mortality Among Elderly Patients with Community-acquired Pneumonia

Ruhnke, Gregory W.; Coca-Perraillon, Marcelo; Kitch, Barrett T.; Cutler, David M.

doi:10.1016/j.amjmed.2010.08.019

Cited by 88 publications

(64 citation statements)

References 35 publications

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“…Additionally, several county governments have provided free influenza vaccines to all the county's elderly population and pneumococcal vaccinations to all the county's older elderly (age 75 and older) since 2000 33,34 . Other studies have also shown declining mortality rates among patients with pneumonia over the past 10-20 years 17,35 .…”

Section: Discussionmentioning

confidence: 97%

“…Furthermore, we found that mortality gaps between elderly and young patients narrowed over time; namely, the decline in the mortality rate among elderly patients was faster than that among young patients. It is probable that influenza and pneumococcal vaccination rates among elderly patients increased over time because of gradual implementation of government-sponsored vaccination programs for the elderly 17,[32][33][34] . In 1998, a national government-sponsored influenza vaccination program for the elderly (age 65 and older) was introduced in Taiwan.…”

Section: Discussionmentioning

confidence: 99%

“…The most important reason why the 30-day mortality rate is used by the CMS is because mortality within 30 days is pneumonia-related, while mortality after 30 days is primarily due to comorbid conditions 14 . The period of 30 days after admission is used in pneumonia outcome studies [15][16][17] . Thirty-day mortality was calculated by linking inpatient admission records with withdrawal certificate records 10,18,19 .…”

Section: Study Variablesmentioning

confidence: 99%

See 2 more Smart Citations

Factors Associated with Pneumonia Outcomes: A Nationwide Population-Based Study over the 1997–2008 Period

Chang

Tung

2011

J GEN INTERN MED

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Study Variablesmentioning

confidence: 99%

See 1 more Smart Citation

Factors Associated with Pneumonia Outcomes: A Nationwide Population-Based Study over the 1997–2008 Period

Chang

Tung

2011

J GEN INTERN MED

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“…Other reports have found that pneumococcal and influenza vaccination were associated with reductions in mortality and hospitalizations in patients with CAP. [23][24][25] Offering both pneumococcal and influenza vaccination to the elderly can improve 30-day mortality in patients with CAP. The severity and extension of pneumonia, an inadequate response to infection, and low functional status were the main factors associated with mortality in elderly patients with CAP.…”

Section: Discussionmentioning

confidence: 99%

“…All statistical tests were 2-tailed and statistical significance was established as p value <0.05. The statistical analysis was made using the SPSS v. 23 …”

Section: Methodsmentioning

confidence: 99%

Factors associated with 30-day mortality in elderly inpatients with community acquired pneumonia during 2 influenza seasons

Torner

Izquierdo

Soldevila

et al. 2016

Human Vaccines & Immunotherapeutics

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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 D 146). Pneumococcal vaccination had a significant protective effect (OR 0.68, 95% CI, 0.48-0.96; p D 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 D 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 D 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 D 0.005), and ICU admittance (aOR2.56, 95% CI, 1.27-5.16; p D 0.009); length of stay (aOR 1.56, 95% CI, 1.02 -2.40; p D 0.04) and cardio-respiratory resuscitation (aOR 7.75, 95% CI, 1.20 -49.98; p D 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.

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Association of Diagnostic Coding With Trends in Hospitalizations and Mortality of Patients With Pneumonia, 2003-2009

Lindenauer¹,

Lagu²,

Shieh³

et al. 2012

JAMA

273

236

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NEUMONIA IS A LEADING CAUSE of morbidity and mortality among US adults, resulting in more than 1 million annual hospital admissions and accounting for more than $10.5 billion in aggregate costs. 1,2 Given its public health significance, pneumonia has been the target of quality improvement activities for nearly 2 decades. This began with the publication of clinical practice guidelines in the early 1990s, 3 was followed by a series of statewide and national quality improvement initiatives, 4 and more recently has included public reporting and pay-for-performance programs led by the Joint Commission and the Centers for Medicare & Medicaid Services (CMS) and other payers. 5,6 These efforts have been associated with favorable trends in adherence to recommended processes of care, 7-10 including the choice and timely administration of antibiotics. At the same time, several epidemiologic analyses have reported that survival among pneumonia patients appears to be improving, suggesting that clinical advances, improvements in health care quality, or both are having beneficial effects. 11-14 Although the decline in pneumonia mortality may reflect real improvements in clinical outcomes, in the absence of any For editorial comment see p 1433.

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Marked Reduction in 30-Day Mortality Among Elderly Patients with Community-acquired Pneumonia

Cited by 88 publications

References 35 publications

Factors Associated with Pneumonia Outcomes: A Nationwide Population-Based Study over the 1997–2008 Period

Factors Associated with Pneumonia Outcomes: A Nationwide Population-Based Study over the 1997–2008 Period

Factors associated with 30-day mortality in elderly inpatients with community acquired pneumonia during 2 influenza seasons

Association of Diagnostic Coding With Trends in Hospitalizations and Mortality of Patients With Pneumonia, 2003-2009

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