Risk factors for 30-day mortality in elderly patients with lower respiratory tract infection: Community-based study

Margaret S. Houston, Marc D. Silverstein, Vera Jean Suman

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)2190-2195
Number of pages6
JournalArchives of Internal Medicine
Volume157
Issue number19
StatePublished - 1997

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Respiratory Tract Infections
Odds Ratio
Mortality
Confidence Intervals
Pneumonia
Anti-Bacterial Agents
Confusion
Lethargy
Bronchitis
Nursing Homes
Nervous System Diseases
Nervous System
Medical Records
Inpatients
Cause of Death
Neoplasms
Eating
Logistic Models
Population

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Risk factors for 30-day mortality in elderly patients with lower respiratory tract infection : Community-based study. / Houston, Margaret S.; Silverstein, Marc D.; Suman, Vera Jean.

In: Archives of Internal Medicine, Vol. 157, No. 19, 1997, p. 2190-2195.

Research output: Contribution to journalArticle

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abstract = "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.",
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