Sobrevida a largo plazo en adultos inmunocompetentes mayores de 60 años hospitalizados por neumonía adquirida en la comunidad / Long-term survival of immunocompetent patients older than 60 years hospitalized for community-acquired pneumonia

ABSTRACT

Background: A reduction in long-term survival of adult patients hospitalized with community-acquired pneumonia (CAP), especially older people with múltiple comorbidities, has been reported. Aim: To examine the clinical variables associated to mortality at 72 months of adult patients older than 60 years hospitalized with CAP and compare their mortality with a control group matched for age, gender and place of admission. Material and Methods: Prospective assessment of 465 immunocompetent patients aged 61 to 101 years, hospitalized for CAP in a teaching hospital. Hospital and 30 day mortality was obtained from medical records. Seventy two months survival ofthe 424 patients who were discharged olive, was compared with a group of 851 patients without pneumonia paired for gender and age. Mortality at 72 months was obtained from death certificates. Results: Eighty seven percent of patients had comorbidity. The median hospital length ofstay was 10 days, 8.8% died in the hospital, 29.7% at one year follow-up and 61.9%o at 6 years. The actuarial survival at six years was similar in the cohort of adults hospitalized with CAP and the control group matched for age, gender and site of care. In a multivariate analysis, the clinical variables associated with increased risk of dying during long-term follow-up were older age, chronic cardiovascular and neurological diseases, malignancy, absence of fever, low C-reactive protein at hospital admission and high-risk parameters of the Fine índex. Conclusions: Advanced age, some specific comorbidities, poor systemic inflammatory response at admission and high risk parameters of the Fine Index were associated to increased risk of dying on long-term follow-up among older adults hospitalized for CAP.