60 years of age. A total of 588,147 participants were randomly selected for senior cohort using 10% simple random sampling. We identified senile (> 65 years old) patientswho underwent hip fracture surgery from January 2005 to December 2014 and those who developed pneumonia during hospitalization from the NHIS-Senior cohort. The index date of hip fracture occurrence was defined as the date of admission to the acute care hospital. The last date of follow-up was defined as the date of death or 31 December 2015, whichever came first. A multivariable-adjusted Cox proportional hazards model was used to investigate the effects of pneumonia on all-cause mortality.
RESULTS:
During the enrollment period, a total of 14,736 patients, who were older than 65 years, underwent hip fracture surgeries. Among them, 1,629 patients (11.05%) developed pneumonia during the hospitalization. The pneumoniaincidence was 16.39% (601/3,666) in menpatients and 9.29% (1,028/10,042) in womenpatients. Compared to 13,107 non-pneumoniapatients, adjusted relative risk (aRR) of death in pneumoniapatients was 2.69 (95% confidence interval [CI], 2.14–3.38; P < 0.001) within postoperative 30-day, 3.40 (95% CI, 3.01–3.83; P < 0.001) within postoperative 90-day, 2.86 (95% CI, 2.61–3.15; P < 0.001) within postoperative 180-day and 2.31 (95% CI, 2.14–2.50; P < 0.001) within postoperative 1-year. According to patient's age, the aRR of death in pneumoniapatients was 5.75 (95% CI, 2.89–11.43) in adultsaged < 70 years, 5.14 (95% CI, 4.08–6.46) in those aged 70–79 years, 3.29 (95% CI, 2.81–3.86) in those aged 80–89 years and 2.02 (95% CI, 1.52–2.69) in those aged ≥ 90 years. The aRR was 3.63 (95% CI, 3.01–4.38) in menpneumoniapatients, and 3.27 (95% CI, 2.80–3.83) in womenpneumoniapatients.