Age-related differences in management and outcomes in hospitalized healthy and well-functioning bacteremic pneumococcal pneumonia patients

A cohort study

Luis A. Ruiz, Pedro P. España, Ainhoa Gómez, Amaia Bilbao, Carmen Jaca, Amaia Arámburu, Alberto Capelastegui, Marcos Restrepo, Rafael Zalacain

Research output: Contribution to journalArticle

Abstract

Background: Limited data are available regarding fit and healthy patients with pneumonia at different ages. We evaluated the association of age with clinical presentation, serotype and outcomes among healthy and well-functioning patients hospitalized for bacteremic pneumococcal community-acquired pneumonia. Methods: We performed a prospective cohort study of consecutive healthy and well-functioning patients hospitalized for this type of pneumonia. Patients were stratified into younger (18 to 64 years) and older (≥65 years) groups. Results: During the study period, 399 consecutive patients were hospitalized with bacteremic pneumococcal pneumonia. We included 203 (50.8%) patients who were healthy and well-functioning patients, of whom 71 (35%) were classified as older. No differences were found in antibiotic treatment, treatment failure rate, antibiotic resistance, or serotype, except for serotype 7F that was less common in older patients. In the adjusted multivariate analysis, the older patients had higher 30-day mortality (OR 6.83; 95% CI 1.22-38.22; P = 0.028), but were less likely to be admitted to the ICU (OR 0.14; 95% CI 0.05-0.39; P < 0.001) and had shorter hospital stays (OR 0.71; 95% CI 0.54-0.94; P = 0.017). Conclusions: Healthy and well-functioning older patients have higher mortality than younger patients, but nevertheless, ICU admission was less likely and hospital stays were shorter. These results suggest that the aging process is a determinant of mortality, beyond the functional status of patients with bacteremic pneumococcal pneumonia.

Original languageEnglish (US)
Article number130
JournalBMC Geriatrics
Volume17
Issue number1
DOIs
StatePublished - Jun 20 2017

Fingerprint

Pneumococcal Pneumonia
Cohort Studies
Pneumonia
Mortality
Length of Stay
Microbial Drug Resistance
Treatment Failure

Keywords

  • Bacteremic pneumococcal pneumonia
  • Community-acquired pneumonia
  • Pneumonia in older people

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Age-related differences in management and outcomes in hospitalized healthy and well-functioning bacteremic pneumococcal pneumonia patients : A cohort study. / Ruiz, Luis A.; España, Pedro P.; Gómez, Ainhoa; Bilbao, Amaia; Jaca, Carmen; Arámburu, Amaia; Capelastegui, Alberto; Restrepo, Marcos; Zalacain, Rafael.

In: BMC Geriatrics, Vol. 17, No. 1, 130, 20.06.2017.

Research output: Contribution to journalArticle

Ruiz, Luis A. ; España, Pedro P. ; Gómez, Ainhoa ; Bilbao, Amaia ; Jaca, Carmen ; Arámburu, Amaia ; Capelastegui, Alberto ; Restrepo, Marcos ; Zalacain, Rafael. / Age-related differences in management and outcomes in hospitalized healthy and well-functioning bacteremic pneumococcal pneumonia patients : A cohort study. In: BMC Geriatrics. 2017 ; Vol. 17, No. 1.
@article{48dd95fa0bac4ff6a6189585673857f3,
title = "Age-related differences in management and outcomes in hospitalized healthy and well-functioning bacteremic pneumococcal pneumonia patients: A cohort study",
abstract = "Background: Limited data are available regarding fit and healthy patients with pneumonia at different ages. We evaluated the association of age with clinical presentation, serotype and outcomes among healthy and well-functioning patients hospitalized for bacteremic pneumococcal community-acquired pneumonia. Methods: We performed a prospective cohort study of consecutive healthy and well-functioning patients hospitalized for this type of pneumonia. Patients were stratified into younger (18 to 64 years) and older (≥65 years) groups. Results: During the study period, 399 consecutive patients were hospitalized with bacteremic pneumococcal pneumonia. We included 203 (50.8{\%}) patients who were healthy and well-functioning patients, of whom 71 (35{\%}) were classified as older. No differences were found in antibiotic treatment, treatment failure rate, antibiotic resistance, or serotype, except for serotype 7F that was less common in older patients. In the adjusted multivariate analysis, the older patients had higher 30-day mortality (OR 6.83; 95{\%} CI 1.22-38.22; P = 0.028), but were less likely to be admitted to the ICU (OR 0.14; 95{\%} CI 0.05-0.39; P < 0.001) and had shorter hospital stays (OR 0.71; 95{\%} CI 0.54-0.94; P = 0.017). Conclusions: Healthy and well-functioning older patients have higher mortality than younger patients, but nevertheless, ICU admission was less likely and hospital stays were shorter. These results suggest that the aging process is a determinant of mortality, beyond the functional status of patients with bacteremic pneumococcal pneumonia.",
keywords = "Bacteremic pneumococcal pneumonia, Community-acquired pneumonia, Pneumonia in older people",
author = "Ruiz, {Luis A.} and Espa{\~n}a, {Pedro P.} and Ainhoa G{\'o}mez and Amaia Bilbao and Carmen Jaca and Amaia Ar{\'a}mburu and Alberto Capelastegui and Marcos Restrepo and Rafael Zalacain",
year = "2017",
month = "6",
day = "20",
doi = "10.1186/s12877-017-0518-0",
language = "English (US)",
volume = "17",
journal = "BMC Geriatrics",
issn = "1471-2318",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Age-related differences in management and outcomes in hospitalized healthy and well-functioning bacteremic pneumococcal pneumonia patients

T2 - A cohort study

AU - Ruiz, Luis A.

AU - España, Pedro P.

AU - Gómez, Ainhoa

AU - Bilbao, Amaia

AU - Jaca, Carmen

AU - Arámburu, Amaia

AU - Capelastegui, Alberto

AU - Restrepo, Marcos

AU - Zalacain, Rafael

PY - 2017/6/20

Y1 - 2017/6/20

N2 - Background: Limited data are available regarding fit and healthy patients with pneumonia at different ages. We evaluated the association of age with clinical presentation, serotype and outcomes among healthy and well-functioning patients hospitalized for bacteremic pneumococcal community-acquired pneumonia. Methods: We performed a prospective cohort study of consecutive healthy and well-functioning patients hospitalized for this type of pneumonia. Patients were stratified into younger (18 to 64 years) and older (≥65 years) groups. Results: During the study period, 399 consecutive patients were hospitalized with bacteremic pneumococcal pneumonia. We included 203 (50.8%) patients who were healthy and well-functioning patients, of whom 71 (35%) were classified as older. No differences were found in antibiotic treatment, treatment failure rate, antibiotic resistance, or serotype, except for serotype 7F that was less common in older patients. In the adjusted multivariate analysis, the older patients had higher 30-day mortality (OR 6.83; 95% CI 1.22-38.22; P = 0.028), but were less likely to be admitted to the ICU (OR 0.14; 95% CI 0.05-0.39; P < 0.001) and had shorter hospital stays (OR 0.71; 95% CI 0.54-0.94; P = 0.017). Conclusions: Healthy and well-functioning older patients have higher mortality than younger patients, but nevertheless, ICU admission was less likely and hospital stays were shorter. These results suggest that the aging process is a determinant of mortality, beyond the functional status of patients with bacteremic pneumococcal pneumonia.

AB - Background: Limited data are available regarding fit and healthy patients with pneumonia at different ages. We evaluated the association of age with clinical presentation, serotype and outcomes among healthy and well-functioning patients hospitalized for bacteremic pneumococcal community-acquired pneumonia. Methods: We performed a prospective cohort study of consecutive healthy and well-functioning patients hospitalized for this type of pneumonia. Patients were stratified into younger (18 to 64 years) and older (≥65 years) groups. Results: During the study period, 399 consecutive patients were hospitalized with bacteremic pneumococcal pneumonia. We included 203 (50.8%) patients who were healthy and well-functioning patients, of whom 71 (35%) were classified as older. No differences were found in antibiotic treatment, treatment failure rate, antibiotic resistance, or serotype, except for serotype 7F that was less common in older patients. In the adjusted multivariate analysis, the older patients had higher 30-day mortality (OR 6.83; 95% CI 1.22-38.22; P = 0.028), but were less likely to be admitted to the ICU (OR 0.14; 95% CI 0.05-0.39; P < 0.001) and had shorter hospital stays (OR 0.71; 95% CI 0.54-0.94; P = 0.017). Conclusions: Healthy and well-functioning older patients have higher mortality than younger patients, but nevertheless, ICU admission was less likely and hospital stays were shorter. These results suggest that the aging process is a determinant of mortality, beyond the functional status of patients with bacteremic pneumococcal pneumonia.

KW - Bacteremic pneumococcal pneumonia

KW - Community-acquired pneumonia

KW - Pneumonia in older people

UR - http://www.scopus.com/inward/record.url?scp=85020886431&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85020886431&partnerID=8YFLogxK

U2 - 10.1186/s12877-017-0518-0

DO - 10.1186/s12877-017-0518-0

M3 - Article

VL - 17

JO - BMC Geriatrics

JF - BMC Geriatrics

SN - 1471-2318

IS - 1

M1 - 130

ER -