ABSTRACT
Objective:To investigate the prognostic factors of community-acquired pneumonia(CAP)in the elderly.Methods:Clinical and laboratory data of elderly patients(≥65 years old)hospitalized for CAP in the Department of Respiratory and Critical Care Medicine of Beijing Hospital from January to December 2019 were retrospectively analyzed.The patients were followed up after discharge.The patients were divided into a death group and a survival group according to their prognosis, and long-term mortality risk factors were analyzed by Cox regression.Results:A total of 118 elderly patients hospitalized for CAP with a male-to-female ratio of 1∶1 were included.The follow-up period was 20.7-39.0 months, with a median follow-up time of 29.8 months.The all-cause cumulative mortality rates at 1-2, 3, 6, 12, 24, and 36 months after discharge were 3.4%(4/118), 4.2%(5/118), 5.1%(6/118), 9.3%(11/118), 16.1%(19/118), and 21.6%(24/118), respectively.Pneumonia was the leading cause of death.Multifactorial Cox regression indicated that the Charlson comorbidity index score( HR=1.42, 95% CI: 1.11-1.83, P=0.006), the score of activities of daily living at discharge( HR=0.44, 95% CI: 0.23-0.84, P=0.013), body mass index( HR=0.83, 95% CI: 0.72-0.97, P=0.012), and the level of serum albumin( HR=0.84, 95% CI: 0.73-0.98, P=0.031)were independently associated with long-term mortality. Conclusions:The leading cause of long-term death for elderly CAP patients after discharge is pneumonia.High Charlson comorbidity index scores, lower BMI, low serum albumin levels and low scores of activities of daily living at discharge are independent risk factors for long-term mortality in these patients.Therefore, in order to reduce the occurrence of adverse prognosis and improve the quality of life, a multidimensional, comprehensive assessment and timely intervention should be performed during the acute phase of the disease.