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Arch Intern Med. 1997 Oct 27;157(19):2190-5.

Risk factors for 30-day mortality in elderly patients with lower respiratory tract infection. Community-based study.

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1
Department of Family Medicine, Mayo Clinic, Rochester, Minn., USA.

Abstract

BACKGROUND:

Pneumonia is a major cause of death in the elderly, but there are few studies of risk factors for death that include both ambulatory and nursing home patients.

OBJECTIVE:

To assess factors associated with 30-day mortality in a population-based study of older adults with lower respiratory tract infection.

METHODS:

Identification of (1) a previously identified retrospective cohort of all residents of Rochester, Minn, aged 65 years or older who experienced a first episode of pneumonia or bronchitis during a calendar year and (2) the risk factors associated with 30-day mortality through review of complete inpatient and ambulatory medical records. Logistic regression was used to identify significant independent risk factors for 30-day mortality.

RESULTS:

A total of 413 adults aged 65 years or older were identified. The independent factors for 30-day mortality were atypical symptoms (odds ratio [OR], 4.98; 95% confidence interval [CI], 2.14-11.60), neurologic illness (OR, 3.92; 95% CI, 1.47-6.59), current diagnosis of cancer (OR, 6.2; 95% CI, 2.40-15.99), and recent or current use of antibiotics (OR, 3.13; 95% CI, 1.45-6.77).

CONCLUSIONS:

Malignancy and neurologic disease are well-recognized conditions that identify patients with lower respiratory tract infections who have a high risk of death within 30 days. An atypical presentation with confusion, lethargy, poor eating, or recent or current antibiotic use also identifies patients, with a high risk of 30-day mortality.

PMID:
9342995
[Indexed for MEDLINE]
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