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Risk Factors for 30-Day Mortality in Elderly Patients With Lower Respiratory Tract InfectionCommunity-Based Study
Margaret S. Houston, MD, MPH;
Marc D. Silverstein, MD;
VeraJ. Suman, PhD
Arch Intern Med. 1997;157(19):2190-2195.
Abstract
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Background
Pneumonia is a major cause of death in the elderly, but there are few studies of risk factors for death that include both ambulatory and nursing home patients.
Objective
To assess factors associated with 30-day mortality in a population-based study of older adults with lower respiratory tract infection.
Methods
Identification of (1) a previously identified retrospective cohort of all residents of Rochester, Minn, aged 65 years or older who experienced a first episode of pneumonia or bronchitis during a calendar year and (2) the risk factors associated with 30-day mortality through review of complete inpatient and ambulatory medical records. Logistic regression was used to identify significant independent risk factors for 30-day mortality.
Results
A total of 413 adults aged 65 years or older were identified. The independent factors for 30-day mortality were atypical symptoms (odds ratio [OR], 4.98; 95% confidence interval [CI], 2.14-11.60), neurologic illness (OR, 3.92; 95% CI, 1.47-6.59), current diagnosis of cancer (OR, 6.2; 95% CI, 2.40-15.99), and recent or current use of antibiotics (OR, 3.13; 95% CI, 1.45-6.77).
Conclusions
Malignancy and neurologic disease are well-recognized conditions that identify patients with lower respiratory tract infections who have a high risk of death within 30 days. An atypical presentation with confusion, lethargy, poor eating, or recent or current antibiotic use also identifies patients with a high risk of 30-day mortality.
Arch Intern Med. 1997;157:2190-2195
Author Affiliations
From the Department of Family Medicine (Dr Houston), the Division of Area General Internal Medicine and Department of Health Sciences Research, Section of Clinical Epidemiology (Dr Silverstein), and the Department of Health Sciences Research, Section of Biostatistics (Dr Suman), Mayo Clinic and Foundation, Rochester, Minn.
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