The impact of comorbidities and their stacking on short-and long-term prognosis of patients over 50 with community-acquired pneumonia - Inserm - Institut national de la santé et de la recherche médicale Accéder directement au contenu
Article Dans Une Revue BMC Infectious Diseases Année : 2021

The impact of comorbidities and their stacking on short-and long-term prognosis of patients over 50 with community-acquired pneumonia

Résumé

Background: The prognosis of patients hospitalized with community-acquired pneumonia (CAP) with regards to intensive care unit (ICU) admission, short-and long-term mortality is correlated with patient's comorbidities. For patients hospitalized for CAP, including P-CAP, we assessed the prognostic impact of comorbidities known as at-risk (AR) or high-risk (HR) of pneumococcal CAP (P-CAP), and of the number of combined comorbidities. Methods: Data on hospitalizations for CAP among the French 50+ population were extracted from the 2014 French Information Systems Medicalization Program (PMSI), an exhaustive national hospital discharge database maintained by the French Technical Agency of Information on Hospitalization (ATIH). Their admission diagnosis, comorbidities (nature, risk type and number), other characteristics, and their subsequent hospital stays within the year following their hospitalization for CAP were analyzed. Logistic regression models were used to assess the associations between ICU transfer, short-and 1-year in-hospital mortality and all covariates. Results: From 182,858 patients, 149,555 patients aged ≥ 50 years (nonagenarians 17.8%) were hospitalized for CAP in 2014, including 8270 with P-CAP. Overall, 33.8% and 90.5% had ≥ 1 HR and ≥ 1 AR comorbidity, respectively. Cardiac diseases were the most frequent AR comorbidity (all CAP: 77.4%). Transfer in ICU occurred for 5.4% of CAP patients and 19.4% for P-CAP. Short-term and 1-year in-hospital mortality rates were 10.9% and 23% of CAP patients, respectively, significantly lower for P-CAP patients: 9.2% and 19.8% (HR 0.88 [95% CI 0.84-0.93], p < .0001). Both terms of mortality increased mostly with age, and with the number of comorbidities and combination of AR and HR comorbidities, in addition of specific comorbidities. Conclusions: Not only specific comorbidities, but also the number of combined comorbidities and the combination of AR and HR comorbidities may impact the outcome of hospitalized CAP and P-CAP patients.
Fichier principal
Vignette du fichier
s12879-021-06669-5.pdf (1.16 Mo) Télécharger le fichier
Origine : Fichiers éditeurs autorisés sur une archive ouverte

Dates et versions

inserm-03356877 , version 1 (28-09-2021)

Identifiants

Citer

E Blanc, G Chaize, S Fievez, C Féger, E Herquelot, et al.. The impact of comorbidities and their stacking on short-and long-term prognosis of patients over 50 with community-acquired pneumonia. BMC Infectious Diseases, 2021, 21 (1), pp.949. ⟨10.1186/s12879-021-06669-5⟩. ⟨inserm-03356877⟩
30 Consultations
22 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More