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 Jul 17;36(1):146.
doi: 10.1007/s40520-024-02808-5.

Impact of lower-respiratory tract infections on healthcare utilization and mortality in older adults: a Swedish population-based cohort study

Ahmad Abbadi  1   2 , Susanna Gentili  3 , Eleana Tsoumani  4 , Agnes Brandtmüller  5 , Merle K Hendel  3 , Stina Salomonsson  6 , Amaia Calderón-Larrañaga  3   7 , Davide L Vetrano  3   7
Affiliations

Impact of lower-respiratory tract infections on healthcare utilization and mortality in older adults: a Swedish population-based cohort study

Ahmad Abbadi et al. Aging Clin Exp Res. .

Abstract

Background: Lower respiratory tract infections (LRTIs) have an immediate significant impact on morbidity and mortality among older adults. However, the impact following the infectious period of LRTI remains understudied. We aimed to assess the short- to long-term impact of LRTIs on hospitalization, mortality, and healthcare utilization in older adults.

Methods: Data from the Swedish National Study of Aging and Care in Kungsholmen (SNAC-K) was analyzed, with data from 2001 to 2019 for mortality and 2001-2016 for healthcare utilization. LRTI-exposed participants were identified and matched with LRTI-nonexposed based on sociodemographics, lifestyle factors, and functional and clinical characteristics. Statistical models evaluated post-LRTI hospitalization risk, days of inpatient hospital admissions, healthcare visits, and mortality.

Results: 567 LRTIs-exposed participants during the study period and were matched with 1.701 unexposed individuals. LRTI-exposed individuals exhibited increased risk of hospitalization at 1-year (HR 2.14, CI 1.74, 2.63), 3-years (HR 1.74, CI 1.46, 2.07), and 5-years (HR 1.59, CI 1.33, 1.89). They also experienced longer post-LRTI hospital stays (IRR 1.40, CI 1.18, 1.66), more healthcare visits (IRR 1.47, CI 1.26, 1.71), specialist-care visits (IRR 1.46, CI 1.24, 1.73), and hospital admissions (IRR 1.57, CI 1.34, 1.83) compared to nonexposed participants over 16-years of potential follow-up. Additionally, the 19-year risk of mortality was higher among LRTI-exposed participants (HR 1.45, CI 1.24, 1.70). Men exhibited stronger associations with these risks compared to women.

Conclusions: LRTIs pose both short- and long-term risks for older adults, including increased risks of mortality, hospitalization, and healthcare visits that transpire beyond the acute infection period, although these effects diminish over time. Men exhibit higher risks across these outcomes compared to women. Given the potential preventability of LRTIs, further public health measures to mitigate infection risk are warranted.

Keywords: Healthcare use; Lower respiratory tract infections; Mortality; Older adults; Sex stratification.

PubMed Disclaimer

Conflict of interest statement

Eleana Tsoumani, Agnes Brandtmüller and Stina Salomonsson work for MSD (Merck Sharp & Dohme). The other authors declare no conflict of interest.

References

    1. Troeger C, Blacker BF, Khalil IA, Rao PC, Cao S, Zimsen SRM, et al. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet Infect Dis. 2018;18:1191–1210. doi: 10.1016/S1473-3099(18)30310-4. - DOI - PMC - PubMed
    1. Feldman C, Shaddock E. Epidemiology of lower respiratory tract infections in adults. Expert Rev Respir Med. 2019;13:63–77. doi: 10.1080/17476348.2019.1555040. - DOI - PubMed
    1. Murray CJL, Aravkin AY, Zheng P, Abbafati C, Abbas KM, Abbasi-Kangevari M, et al. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the global burden of disease study 2019. Lancet. 2020;396:1223–1249. doi: 10.1016/S0140-6736(20)30752-2. - DOI - PMC - PubMed
    1. Doxey MC, Burkart K, Bryazka D, Dominguez R-MV, Abdoli A, Aboagye RG, et al. Age–sex differences in the global burden of lower respiratory infections and risk factors, 1990–2019: results from the global burden of disease study 2019. Lancet Infect Dis. 2022;22:1626–47. doi: 10.1016/S1473-3099(22)00510-2. - DOI - PMC - PubMed
    1. Venkatesan P. COVID-19 diagnostics-not at the expense of other diseases. Lancet Microbe. 2020;1:e64. doi: 10.1016/S2666-5247(20)30041-0. - DOI - PMC - PubMed

LinkOut - more resources