Older adults treated for community-acquired pneumonia (CAP) are likely to have a poorer quality of life and be at a greater risk of death in the year after they are discharged from a hospital compared to the general public, a study reports.
The study, “The Impact Of Community-Acquired Pneumonia On The Health-Related Quality-Of-Life In Elderly,” was published in the journal BMC Infectious Diseases.
Pneumonia is characterized by inflammation of the microscopic air sacs of lungs. CAP causes considerable disease and economic burden, and approximately 45 percent of all cases occur among people age 65 or older.
The study’s goal was to quantify differences in health-related quality of life over one year in community-dwelling elderly with and without CAP. Researchers also wanted to find possible health-related life quality differences between radiologically confirmed and non-confirmed, or suspected, CAP cases.
Researchers analyzed a subgroup of patients who had enrolled in a previously conducted clinical trial (CHO-CAP, NCT00812084), a placebo-controlled, double-blinded study evaluating the effectiveness of a 13-valent pneumococcal conjugate vaccine in 84,496 community-dwelling elderly in the Netherlands. All enrolled patients were 65 or older.
The subgroup of patients analyzed by the team included 562 with suspected CAP and 1,145 healthy individuals. Health-related quality of life was assessed one or two weeks after hospital discharge/admission and one, six and 12 months after, using the Euroqol EQ-5D-3L and Short Form-36 Health survey questionnaires.
Researchers also assessed the one-year quality-adjusted life years (QALY), a measure that reflects both health and quality of life, in both groups.
Results showed that QALY was 0.68 for suspected pneumonia cases and 0.81 for healthy individuals, meaning that CAP patients were seen to have both poorer health and life quality.
Death rates during the 12 months after hospital discharge was also higher among pneumonia patients — 8.4 percent among patients with CAP and 1.2 percent in healthy individuals.
Health-related quality of life was always lower among CAP patients during follow-up compared to those in the healthy control group. However, no significant differences were seen here between patients with radiologically confirmed and those with suspected CAP.
“Community-acquired pneumonia was associated with a six-fold increased mortality and 16% lower quality-of-life in the post-discharge year among patients surviving hospitalization for community-acquired pneumonia, compared to non-diseased persons,” the researchers concluded.
The team suggests that, given the QALY loss and higher mortality due to CAP in the elderly, further studies should focus on strategies to prevent pneumonia in this patient population.