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  • Title: [Long-term survival of immunocompetent patients older than 60 years hospitalized for community-acquired pneumonia].
    Author: Saldías P F, Maturana O R, Román O F, Díaz P O.
    Journal: Rev Med Chil; 2013 Jul; 141(7):831-43. PubMed ID: 24356731.
    Abstract:
    BACKGROUND: A reduction in long-term survival of adult patients hospitalized with community-acquired pneumonia (CAP), especially older people with múltiple comorbidities, has been reported. AIM: To examine the clinical variables associated to mortality at 72 months of adult patients older than 60 years hospitalized with CAP and compare their mortality with a control group matched for age, gender and place of admission. MATERIAL AND METHODS: Prospective assessment of 465 immunocompetent patients aged 61 to 101 years, hospitalized for CAP in a teaching hospital. Hospital and 30 day mortality was obtained from medical records. Seventy two months survival of the 424 patients who were discharged olive, was compared with a group of 851 patients without pneumonia paired for gender and age. Mortality at 72 months was obtained from death certificates. RESULTS: Eighty seven percent of patients had comorbidity. The median hospital length of stay was 10 days, 8.8% died in the hospital, 29.7% at one year follow-up and 61.9%o at 6 years. The actuarial survival at six years was similar in the cohort of adults hospitalized with CAP and the control group matched for age, gender and site of care. In a multivariate analysis, the clinical variables associated with increased risk of dying during long-term follow-up were older age, chronic cardiovascular and neurological diseases, malignancy, absence of fever, low C-reactive protein at hospital admission and high-risk parameters of the Fine índex. CONCLUSIONS: Advanced age, some specific comorbidities, poor systemic inflammatory response at admission and high risk parameters of the Fine Index were associated to increased risk of dying on long-term follow-up among older adults hospitalized for CAP.
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