Incremental risk of long-term mortality with increased burden of comorbidity in hospitalized patients with pneumonia

Mohammed Yousufuddin, Jessica Shultz, Taylor Doyle, Hamid Rehman, Mohammad H Murad

Research output: Contribution to journalArticle

Abstract

Background: Patients hospitalized for pneumonia often have concurrent comorbid conditions (CCs). The influence of CCs on the risk of subsequent death is not fully understood. Methods: We examined adults hospitalized for pneumonia between 1996 through 2015 at Mayo Clinic for the presence of 20 priori selected CCs. We estimated cumulative all-cause mortality by number of CCs using multivariable Cox regression model. Results: Study comprised of 9580 adults (age 70 ± 17.0 years, men 53%, whites 88%) with median number of CCs 3 (interquartile 1–4), and overall deaths 6032 (62.9%) during 50,934 person-years of follow up (118.5 deaths/1000 person-years). After adjustment, any single comorbid condition was associated with 9% greater risk of death (95% confidence interval 1.08–1.11, P < 0.0001). When study cohort was stratified according to number of comorbidities (none, 1, 2, 3, 4, 5, and ≥6 CCs), the risk of death increased as the number of CCs increased (33 for no CCs vs 252 deaths for ≥6 CCs per 1000 person-years). Conclusions: Long-term mortality after hospitalization for pneumonia increases as the burden of comorbidities increases. Therefore, a simple comorbidity count help improve prognostic accuracy in identifying patients at increased risk of death following an episode of pneumonia.

Original languageEnglish (US)
JournalEuropean Journal of Internal Medicine
DOIs
StateAccepted/In press - Jan 1 2018

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Comorbidity
Pneumonia
Mortality
Proportional Hazards Models
Hospitalization
Cohort Studies
Confidence Intervals

Keywords

  • Comorbidity
  • Mortality
  • Pneumonia

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Incremental risk of long-term mortality with increased burden of comorbidity in hospitalized patients with pneumonia. / Yousufuddin, Mohammed; Shultz, Jessica; Doyle, Taylor; Rehman, Hamid; Murad, Mohammad H.

In: European Journal of Internal Medicine, 01.01.2018.

Research output: Contribution to journalArticle

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abstract = "Background: Patients hospitalized for pneumonia often have concurrent comorbid conditions (CCs). The influence of CCs on the risk of subsequent death is not fully understood. Methods: We examined adults hospitalized for pneumonia between 1996 through 2015 at Mayo Clinic for the presence of 20 priori selected CCs. We estimated cumulative all-cause mortality by number of CCs using multivariable Cox regression model. Results: Study comprised of 9580 adults (age 70 ± 17.0 years, men 53{\%}, whites 88{\%}) with median number of CCs 3 (interquartile 1–4), and overall deaths 6032 (62.9{\%}) during 50,934 person-years of follow up (118.5 deaths/1000 person-years). After adjustment, any single comorbid condition was associated with 9{\%} greater risk of death (95{\%} confidence interval 1.08–1.11, P < 0.0001). When study cohort was stratified according to number of comorbidities (none, 1, 2, 3, 4, 5, and ≥6 CCs), the risk of death increased as the number of CCs increased (33 for no CCs vs 252 deaths for ≥6 CCs per 1000 person-years). Conclusions: Long-term mortality after hospitalization for pneumonia increases as the burden of comorbidities increases. Therefore, a simple comorbidity count help improve prognostic accuracy in identifying patients at increased risk of death following an episode of pneumonia.",
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