Long-term follow-up of mortality in patients with community-acquired pneumonia

November 21, 2003

A new study shows that patients who recover from community-acquired pneumonia (CAP) experience an increased risk of death even up to 5 years after recovery compared to age-matched controls.

The study, by Dr. Eric Mortensen of the University of Texas Health Sciences Center in San Antonio, published in the December 15 issue of Clinical Infectious Diseases, identifies factors that appear to play a significant role in long-term mortality following an episode of acute pneumonia. Patients who survived the initial episode of pneumonia for at least 90 days, and who did not have HIV infection, were enrolled and followed for an average of almost 6 years. Factors predicting an increased risk of death during the follow-up period included age, nutritional status, preexisting illnesses ("comorbidity"), nursing home residence, male sex, and less than a college education. The severity of the pneumonia was not a predictive factor in long-term mortality. In fact, patients with a lower grade of fever on presentation had a higher long-term mortality than those with a higher grade of fever. Overall, in this multicenter study, about one-third of patients who survived for 90 days died over the next 6 years.

Previous studies have examined this issue but were generally smaller in size and often did not distinguish short-term mortality, presumably from the pneumonia, from long-term mortality, arising from other factors. Although the presence of other illnesses (comorbidity) might seem to be the logical explanation for the increased risk of death, some studies, like this one, have found that comorbidity is not the whole answer. Unfortunately, many of the other risk factors for increased long-term mortality are related to intrinsic characteristics of the patient, and are largely unchangeable by medical care.

An accompanying editorial in the same issue, written by Dr. Thomas Marrie of the University of Alberta, points out that some of the factors that might be helpful in fighting the acute pneumonia could be detrimental in the long run. For example, some patients seem to respond to infection with a more pronounced inflammatory reaction than others. While this might help in the acute situation, such factors might accelerate other processes such as arteriosclerosis (hardening of the arteries) over longer periods. However, these hypotheses remain speculative.
Founded in 1979, Clinical Infectious Diseases publishes clinical articles twice monthly in a variety of areas of infectious disease, and is one of the most highly regarded journals in this specialty. It is published under the auspices of the Infectious Diseases Society of America (IDSA), based in Alexandria, Va., a professional society representing more than 7,000 physicians and scientists who specialize in infectious diseases.

Infectious Diseases Society of America

Related Pneumonia Articles from Brightsurf:

Vaccine proves effective against the most severe type of pneumonia
A pneumococcal vaccine was effective at protecting children in Laos against the most severe type of pneumonia, a new study has found.

Osteoporosis treatment may also protect against pneumonia
A recent study published in the Journal of Bone and Mineral Research found that nitrogen-containing bisphosphonates (N-BPs) such as alendronate, which are widely used to treat postmenopausal osteoporosis, are linked with lower risks of pneumonia and of dying from pneumonia.

Elderly patients with pneumonia twice as likely to die as those with broken hips, yet underestimate the danger of pneumonia
Elderly patients who are hospitalised with pneumonia are twice as likely to die as those hospitalised with hip fractures -- yet many elderly people fail to accurately assess their risk of pneumonia, concludes research due to be presented at the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID).

Pneumonia recovery reprograms immune cells of the lung
Researchers have determined that after lungs recover from infection, alveolar macrophages (immune cells that live in the lungs and help protect the lungs against infection) are different in multiple ways and those differences persist indefinitely.

Skin and mucous membrane lesions as complication of pneumonia
Painful inflammatory lesions of the skin and mucous membranes may occur in children who develop bacterial pneumonia.

Vaccine reduces likelihood of severe pneumonia
A new study has found severe pneumonia decreases by 35 per cent in children who receive a vaccine against a pneumonia-causing bacteria.

Bacteria in pneumonia attack using bleaching agent
Research shows that bacteria use hydrogen peroxide to weaken the immune system and cause pneumonia.

Many kids with pneumonia get unnecessary antibiotics, chest X-rays
Preschool children with community-acquired pneumonia often receive unnecessary tests and treatment at outpatient clinics and emergency departments, according to a nationally representative study led by Todd Florin, M.D., MSCE, from Ann & Robert H.

Certain psychiatric drugs linked with elevated pneumonia risk
A review of published studies indicates that use of benzodiazepines and benzodiazepine related drugs (BZRDs), which are prescribed to treat various psychiatric diseases, may increase the risk of pneumonia.

Bacterial pneumonia far more dangerous to the heart than viral pneumonia, study finds
Heart complications in patients diagnosed with bacterial pneumonia are more serious than in patients diagnosed with viral pneumonia, according to new research.

Read More: Pneumonia News and Pneumonia Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.