Risk factors for community-acquired pneumonia in immunocompetent seniors.
OBJECTIVE
To identify risk factors for developing community-acquired pneumonia (CAP) in seniors.


METHODS
Nested case-control study.


METHODS
Group Health, a health maintenance organization in Washington state.


METHODS
One thousand one hundred seventy-three immunocompetent seniors with CAP and 2,346 age- and sex-matched controls, sampled during influenza seasons and pre-influenza periods of 2000/01 and 2002/03. CAP cases were presumptively identified according to diagnosis codes assigned to outpatient and inpatient encounters and validated according to review of chest radiograph reports or medical records.


METHODS
Medical records were used to assess body mass, the presence and severity of cardiopulmonary and other chronic diseases, and the presence of functional or cognitive impairments. Use of prescription medications and inpatient, outpatient, and home medical services were identified from administrative databases.


RESULTS
Independent predictors of CAP include the presence and severity of cardiopulmonary disease, low weight and recent weight loss, and poor functional status; 42.0% of pneumonia cases can be attributed to underlying cardiopulmonary disease.


CONCLUSIONS
Seniors with cardiopulmonary disease, poor functional status, low weight, or recent weight loss have a greater risk of developing CAP. Preventative efforts should be targeted toward these individuals.
Jackson
Michael L
ML
Group Health Center for Health Studies, 1730 Minor Ave, Suite 1600, Seattle,WA, USA. jackson.ml@ghc.org
Nelson
Jennifer C
JC
Jackson
Lisa A
LA
D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology; D016022:Case-Control Studies; D017714:Community-Acquired Infections / Q000453:epidemiology*; D005260:Female; D016330:Frail Elderly; D006801:Humans; D007251:Influenza, Human / Q000150:complications / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D011014:Pneumonia / Q000453:epidemiology* / Q000821:virology; D018570:Risk Assessment; D012307:Risk Factors; D014861:Washington / Q000453:epidemiology; D015431:Weight Loss