Incidence, timing and risk factors associated with 1-year mortality after hospitalization for community-acquired pneumonia

Abstract

Objective: To identify the incidence, causes, timing and risk factors associated with 1-year mortality in CAP patients after hospital discharge.

Methods: Adult patients with CAP who were admitted to a tertiary hospital from 2007 to 2011 were prospectively recruited and followed up for 1 year after hospital discharge.

Results: Of the 1284 patients discharged, 93 (7.2%) died within 1-year of leaving hospital. Sixty eight (73.1%) patients died in the first six months. The main reasons for 1-year mortality after hospital discharge were infectious diseases, mainly pneumonia, followed by acute cardiovascular events. Mortality from infectious diseases was higher during the first 6 months (86.1%), while the number of deaths from cardiovascular causes was stable throughout the months of follow-up. After adjustment for confounders, chronic obstructive pulmonary disease, diabetes mellitus, cancer, dementia, rehospitalization within 30 days of hospital discharge and nursing home were independently associated with 1-year mortality. The incidence of long-term mortality increased >50% when ≥4 risk factors were present (P < .001).

Conclusions: Patients mainly died from infectious diseases and acute cardiovascular events in the first six months after leaving hospital for an acute CAP episode. Certain features may help to identify the risk of long-term mortality in CAP patients.

Keywords: Community-acquired pneumonia; Long-term mortality; Risk factors; Timing.