Older Adults Hospitalized for Pneumonia in the United States: Incidence, Epidemiology, and Outcomes
Older Adults Hospitalized for Pneumonia in the United States: Incidence, Epidemiology, and Outcomes
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DOI：
10.1111/jgs.16327
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发表时间：
2020-01-09
影响因子：
6.3
通讯作者：
Ramirez, Julio A.
中科院分区：
文献类型：
--
作者：
Arnold, Forest W.;Reyes Vega, Andrea M.;Ramirez, Julio A.
明确肯塔基州路易斯维尔市社区获得性肺炎（CAP）住院老年患者的当前发病率、流行病学和死亡率，从而估计美国老年人群的CAP负担。确定与早期和晚期结局相关的风险因素。这是一项对路易斯维尔大学肺炎研究中老年人（年龄≥ 65岁）的二次分析，该研究是一项前瞻性基于人群的队列研究，研究对象是2014年6月1日至2016年5月31日期间所有住院的CAP成人。研究地点：肯塔基州路易斯维尔市的所有9家成人急症护理医院。参与者肯塔基州路易斯维尔市的居民，在入选日期之间被诊断为CAP，年龄在65岁或以上。测量CAP的发生率和结局。还评估了总共9个风险因素与临床稳定时间、住院时间（LOS）和死亡率的任何潜在相关性。结果：在为期2年的研究中，路易斯维尔市102264名65岁以上的成年人中，有4760人因CAP住院。老年人CAP住院的发病率为2093/10万。这相当于美国每年有967470名老年人因CAP住院。达到临床稳定的中位时间为2天，中位LOS为6天。30天全因死亡率为17%。1年全因死亡率为38%（829例患者），相当于美国老年人CAP死亡361982例。结论在美国，老年人CAP的估计负担是巨大的。近100万老年人因CAP住院，其中三分之一以上在一年内死亡。
OBJECTIVES To define the current incidence, epidemiology, and mortality of older adult patients hospitalized with community-acquired pneumonia (CAP) in Louisville, KY and thus estimate the burden of CAP in the older adult population of the United States. To define risk factors associated with early and late outcomes. DESIGN This was a secondary analysis of older adults (aged >= 65 years) from the University of Louisville Pneumonia Study, a prospective population-based cohort study of all hospitalized adults with CAP between June 1, 2014, and May 31, 2016. SETTING The study took place in all nine acute care hospitals for adults in Louisville, KY. PARTICIPANTS Residents in the city of Louisville, KY, who were diagnosed with CAP between the inclusion dates were included and who were aged 65 years or older. MEASUREMENTS Incidence of CAP and outcomes were measured. A total of nine risk factors were also assessed for any potential association with time to clinical stability, length of stay (LOS), and mortality. RESULTS During the 2-year study, from a Louisville population of 102 264 adults aged 65 years or older, 4760 were hospitalized with CAP. The incidence of older adults hospitalized with CAP was 2093 per 100 000 population. This corresponds to 967 470 older adults in the United States hospitalized per year with CAP. The median time to clinical stability was 2 days, and the median LOS was 6 days. The 30-day all-cause mortality was 17%. The 1-year all-cause mortality was 38% (829 patients), which corresponds to 361 982 deaths in the United States with CAP in older adults. CONCLUSION The estimated burden of CAP in older adults is substantial in the United States. Nearly 1 million older adults are hospitalized for CAP, and over a third of those die within 1 year.