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Adverse outcomes in patients hospitalized with pneumonia at age 60 or more: A prospective multi-centric hospital-based study in India. | LitMetric

AI Article Synopsis

  • - The study focused on older adults (aged 60+) in India hospitalized with Community-Acquired Pneumonia (CAP) to identify risk factors associated with adverse outcomes like ICU admission and mortality rates.
  • - Data was collected from 1,090 patients, revealing that 39.4% required critical care and there were notable mortality rates of 9.9% during hospitalization and 5% within 30 days post-discharge, with specific health indicators correlating with these outcomes.
  • - Key factors linked to increased risk included high respiratory rates, low oxygen saturation, existing cardiovascular or chronic respiratory diseases, and inadequate antiviral treatment for influenza, highlighting the need for improved management and care strategies for this vulnerable population.

Article Abstract

Background: Limited data exists regarding risk factors for adverse outcomes in older adults hospitalized with Community-Acquired Pneumonia (CAP) in low- and middle-income countries such as India. This multisite study aimed to assess outcomes and associated risk factors among adults aged ≥60 years hospitalized with pneumonia.

Methods: Between December 2018 and March 2020, we enrolled ≥60-year-old adults admitted within 48 hours for CAP treatment across 16 public and private facilities in four sites. Clinical data and nasal/oropharyngeal specimens were collected by trained nurses and tested for influenza, respiratory syncytial virus (RSV), and other respiratory viruses (ORV) using the qPCR. Participants were evaluated regularly until discharge, as well as on the 7th and 30th days post-discharge. Outcomes included ICU admission and in-hospital or 30-day post-discharge mortality. A hierarchical framework for multivariable logistic regression and Cox proportional hazard models identified risk factors (e.g., demographics, clinical features, etiologic agents) associated with critical care or death.

Findings: Of 1,090 CAP patients, the median age was 69 years; 38.4% were female. Influenza viruses were detected in 12.3%, RSV in 2.2%, and ORV in 6.3% of participants. Critical care was required for 39.4%, with 9.9% in-hospital mortality and 5% 30-day post-discharge mortality. Only 41% of influenza CAP patients received antiviral treatment. Admission factors independently associated with ICU admission included respiratory rate >30/min, blood urea nitrogen>19mg/dl, altered sensorium, anemia, oxygen saturation <90%, prior cardiovascular diseases, chronic respiratory diseases, and private hospital admission. Diabetes, anemia, low oxygen saturation at admission, ICU admission, and mechanical ventilation were associated with 30-day mortality.

Conclusion: High ICU admission and 30-day mortality rates were observed among older adults with pneumonia, with a significant proportion linked to influenza and RSV infections. Comprehensive guidelines for CAP prevention and management in older adults are needed, especially with the co-circulation of SARS-CoV-2.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11065220PMC
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0297452PLOS

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