Clinical profile and predictors of mortality in the elderly with community-acquired pneumonia at a tertiary care hospital in South India

Abstract

Introduction: Community-acquired pneumonia (CAP) is a common and the second-most common infectious cause of hospitalization and mortality in the elderly. There are limited data available on age-specific incidence, predictors, pattern of care, and mortality of CAP in the elderly in India. Materials and Methods: We performed a retrospective study of 108 patients over 60 years of age with CAP admitted to a tertiary care center. Death and discharge against medical advice were considered as poor outcomes. Risk factor for poor outcomes was assessed with multivariable variable logistic regression analysis. Results: The mean age of the study population was 70.4 ± 8.1 years. The overall inpatient mortality was 38%. Factors independently associated with mortality were the presence of delirium 5.4 (confidence interval 1.4–14.9;P= 0.009), mechanical ventilation (P ≤ 0.0001), and prolonged hospital stay (P ≤ 0.0001). Patients >75 years had a poor outcome as compared to <75 years (P = 0.09). Bacteremia was present only in 6.1% of patients. Conclusion: CAP in the elderly had a high risk of poor outcomes. Delirium at presentation and need for mechanical ventilation were important risk factors for mortality.

Keywords

• community-acquired pneumonia
• delirium
• elderly
• mortality