title: Factors associated with 30-day mortality in elderly inpatients with community acquired pneumonia during 2 influenza seasons.
abstract: 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 = 146). Pneumococcal vaccination had a significant protective effect (OR 0.68, 95% CI, 0.48-0.96; p = 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 = 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 = 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 = 0.005), and ICU admittance (aOR2.56, 95% CI, 1.27-5.16; p = 0.009); length of stay (aOR 1.56, 95% CI, 1.02 - 2.40; p = 0.04) and cardio-respiratory resuscitation (aOR 7.75, 95% CI, 1.20 - 49.98; p = 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.
authors.affiliation: a CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute , Madrid , Spain.|b Department of Medicine. Public Health Unit , University of Barcelona , Barcelona , Spain.|c Public Health Agency of Catalonia. Generalitat of Catalonia , Barcelona , Spain.
authors.forename: Núria
authors.initials: N
authors.lastname: Torner
authors.affiliation: c Public Health Agency of Catalonia. Generalitat of Catalonia , Barcelona , Spain.
authors.forename: Conchita
authors.initials: C
authors.lastname: Izquierdo
authors.affiliation: a CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute , Madrid , Spain.
authors.forename: Núria
authors.initials: N
authors.lastname: Soldevila
authors.affiliation: a CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute , Madrid , Spain.
authors.forename: Diana
authors.initials: D
authors.lastname: Toledo
authors.affiliation: d Preventive Medicine Service, Complejo Hospitalario de Navarra , Pamplona , Spain.
authors.forename: Judith
authors.initials: J
authors.lastname: Chamorro
authors.affiliation: e Health Consortium of Terrassa , Terrassa , Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Espejo
authors.affiliation: f Preventive Medicine and Public Health. Complejo Hospitalario Universitario , Granada , Spain.
authors.forename: Amelia
authors.initials: A
authors.lastname: Fernández-Sierra
authors.affiliation: a CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute , Madrid , Spain.|b Department of Medicine. Public Health Unit , University of Barcelona , Barcelona , Spain.
authors.forename: Angela
authors.initials: A
authors.lastname: Domínguez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D017714:Community-Acquired Infections / Q000401:mortality*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000401:mortality*; D013030:Spain; D016019:Survival Analysis
keywords: aging; community acquired pneumonia; elderly; mortality