L-676. Long-term Morbidity and Mortality after Hospitalization with Community Acquired Pneumonia: Population Based Cohort Study
Session: Poster Session: The World of Community-Acquired Pneumonia
Saturday, October 25, 2008: 12:00 AM
Room: Hall C
Background: Little is known about the long-term sequelae of community-acquired pneumonia (CAP). Therefore, we describe the long-term morbidity and mortality of patients after pneumonia requiring hospitalization. Methods: Between 2000 and 2002, 3415 adults with CAP admitted to 6 hospitals in Edmonton, Alberta, Canada were prospectively enrolled in a population-based cohort. Post-discharge outcomes through to 2006 were ascertained using multiple linked administrative databases. Outcomes included all-cause mortality and re-hospitalization over a maximum of 5.4 years of follow-up. Results: Follow-up data was available for 3,284 (96%) patients; 66% were ≥65 years of age, 53% were male, and 63% had severe (PSI Class IV-V) pneumonia. Median follow-up was 3.8 years. The 30-day, 1-year and end of study mortality rates were 12%, 28%, and 53%, respectively. Overall, 82 (19%) patients <45 years of age died compared with 1456 (67%) patients ≥65 years [HR 5.07, 95% CI 4.06-6.34]. Males were more likely to die than females over follow-up [971 (56%) vs 767 (49%); HR 1.20, 95% CI 1.13-1.37]. Initial pneumonia severity predicted long-term post-discharge mortality with 92 (15%) of PSI class I-II patients dying vs 616 (82%) PSI class V patients [HR 11.80, 95% CI 4.70-14.70]. Of 2,950 patients who survived their initial CAP hospitalization, 72% were hospitalized again (median 2 admissions over follow-up) and 16% were re-hospitalized with pneumonia. Conclusions: Long-term morbidity and mortality is high following hospitalization for pneumonia. This suggests that patients with pneumonia, especially those with severe disease, may need closer follow-up due to their elevated risk of downstream adverse events and increased health resource utilization.
Dean Eurich, PhD1, Jennie Johnstone, MD2, Sumit Majumdar, MD1, Thomas Marrie, MD3, Yan Jin4 and  J. Johnstone, None., (1)University of Alberta, (2)U of Alberta, Edmonton, AB, Canada, (3)Walter C. Mackenzie Hlth. Sci. Ctr., Edmonton, AB, Canada, (4)Alberta Health and Wellness