Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May-Jun:65:31-39.
doi: 10.1016/j.hrtlng.2024.01.010. Epub 2024 Feb 21.

Socio-demographic and comorbid risk factors for poor prognosis in patients hospitalized with community-acquired bacterial pneumonia in southeastern US

Adeniyi J Idigo  1 , J Michael Wells  2 , Matthew L Brown  3 , Howard W Wiener  4 , Russell L Griffin  4 , Gary Cutter  5 , Sadeep Shrestha  4 , Rachael A Lee  6
Affiliations

Socio-demographic and comorbid risk factors for poor prognosis in patients hospitalized with community-acquired bacterial pneumonia in southeastern US

Adeniyi J Idigo et al. Heart Lung. 2024 May-Jun.

Abstract

Background: How socio-demographic characteristics and comorbidities affect bacterial community-acquired pneumonia (CAP) prognosis during/after hospitalization is important in disease management.

Objectives: To identify predictors of medical intensive care unit (MICU) admission, length of hospital stay (LOS), in-hospital mortality, and bacterial CAP readmission in patients hospitalized with bacterial CAP.

Methods: ICD-9/10 codes were used to query electronic medical records to identify a cohort of patients hospitalized for bacterial CAP at a tertiary hospital in Southeastern US between 01/01/2013-12/31/2019. Adjusted accelerated failure time and modified Poisson regression models were used to examine predictors of MICU admission, LOS, in-hospital mortality, and 1-year readmission.

Results: There were 1956 adults hospitalized with bacterial CAP. Median (interquartile range) LOS was 11 days (6-23), and there were 26 % (513) MICU admission, 14 % (266) in-hospital mortality, and 6 % (117) 1-year readmission with recurrent CAP. MICU admission was associated with heart failure (RR 1.38; 95 % CI 1.17-1.62) and obesity (RR 1.26; 95 % CI 1.04-1.52). Longer LOS was associated with heart failure (adjusted time ratio[TR] 1.27;95 %CI 1.12-1.43), stroke (TR 1.90;95 %CI 1.54,2.35), type 2 diabetes (TR 1.20;95 %CI 1.07-1.36), obesity (TR 1.50;95 %CI 1.31-1.72), Black race (TR 1.17;95 %CI 1.04-1.31), and males (TR 1.24;95 %CI 1.10-1.39). In-hospital mortality was associated with stroke (RR 1.45;95 %CI 1.03-2.04) and age ≥65 years (RR 1.34;95 %CI 1.06-1.68). 1-year readmission was associated with COPD (RR 1.55;95 %CI 1.05-2.27) and underweight BMI (RR 1.74;95 %CI 1.04-2.90).

Conclusions: Comorbidities and socio-demographic characteristics have varying impacts on bacterial CAP in-hospital prognosis and readmission. More studies are warranted to confirm these findings to develop comprehensive care plans and inform public health interventions.

Keywords: Community-acquired bacterial pneumonia; Comorbidities; Length of hospital stay; Mortality; Poor prognosis; Readmission.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest No conflicts exist for AJI, MLB, HWW, RLG, SS, and RAL.

Figures

Figure 1:
Figure 1:
Cohort’s flowchart
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Ramirez JA, Wiemken TL, Peyrani P, Arnold FW, Kelley R, Mattingly WA, et al. Adults Hospitalized With Pneumonia in the United States: Incidence, Epidemiology, and Mortality. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2017;65(11):1806–12. - PubMed
    1. Torres A, Blasi F, Dartois N, Akova M. Which individuals are at increased risk of pneumococcal disease and why? Impact of COPD, asthma, smoking, diabetes, and/or chronic heart disease on community-acquired pneumonia and invasive pneumococcal disease. Thorax. 2015;70(10):984–9. - PMC - PubMed
    1. Jain S, Self WH, Wunderink RG, Fakhran S, Balk R, Bramley AM, et al. Community-Acquired Pneumonia Requiring Hospitalization among U.S. Adults. The New England journal of medicine. 2015;373(5):415–27. - PMC - PubMed
    1. Dela Cruz CS, Wunderink RG, Christiani DC, Cormier SA, Crothers K, Doerschuk CM, et al. Future Research Directions in Pneumonia. NHLBI Working Group Report. American journal of respiratory and critical care medicine. 2018;198(2):256–63. - PMC - PubMed
    1. Jiang HL, Chen HX, Liu W, Fan T, Liu GJ, Mao B. Is COPD associated with increased mortality and morbidity in hospitalized pneumonia? A systematic review and meta-analysis. Respirology (Carlton, Vic). 2015;20(7):1046–54. - PubMed

Publication types