Pneumonia Hospitalization Associated with More Comorbidities, Deaths

The risk of death due to comorbidity after hospitalization for community acquired pneumonia (CAP) is substantial, a recent follow-up study has confirmed. The study, published in PLOS One on February 5 was conducted by Jan C. Holter, of the Department of Internal Medicine at Drammen Hospital in Drammen, Norway.

The researchers recruited and followed up with 259 patients who were admitted to the hospital with CAP between 2008 and 2011. Researchers collected demographic data, as well as information about pre-existing comorbidities, vaccinations, and laboratory test results within 48 hours of patients being admitted to the hospital.

The researchers found that 79 (30.5%) of the 259 patients died within 1804 days of discharge. “The main underlying causes of death during the follow-up period among the 79 non-survivors were COPD (23%), vascular diseases (23%) and malignancy (16%), while only 5% (4 cases) died because of recurrent pneumonia,” according the the researchers.

At one year, the mortality rate among participants was 8.9%, but was 27.1 at the 5-year mark. The researchers report, “In our study, causes of death after CAP were mostly attributed to major chronic diseases and not to recurrent pneumonia,” which is a result that is consistent with previous studies. They also found that older age, the presence of comorbid conditions, and immunocompromization were independent risk factors for long-term mortality.

One finding of this study that raises questions was that a “low serum albumin level at hospital admission was associated with long-term mortality” said the authors. They added that “it remains uncertain whether the effect of hypoalbuminemia on outcome is a causal relationship or whether it is rather a marker of serious disease.”

The researchers concluded that this study confirms the results of previous studies, and extends the “prognostic value of serum albumin level at hospital admission in patients with CAOP to 5-year survival after discharge,” according to the conclusion. They suggest that further studies are necessary to discover whether or not pneumonia etiology has prognostic value.