COMMENTARY

Calculating Risks for Complications and Death With CAP

John G. Bartlett, MD

February 02, 2009

Long-Term Morbidity and Mortality After Hospitalization With Community-Acquired Pneumonia: A Population-Based Cohort Study

This Viewpoint summarizes data from a large study of short- and long term outcomes for patients hospitalized with CAP.

Johnstone J, Eurich DT, Majumdar SR, Jin Y, Marrie TJ.
Medicine 2008;87:329-334

Article Summary

The purpose of this study was to provide information about the long-term sequelae of community-acquired pneumonia (CAP). The study was conducted in Edmonton, Alberta, Canada, from 2000 to 2002 with 3415 patients hospitalized with CAP in 6 hospitals. These patients were followed up prospectively and follow-up data were available from 96% with follow-up for ≥ 5 years in most. Patients were classified by the Pneumonia Severity Index (PSI) of Fine and colleagues^[1] at the time of hospitalization.

In all, 66% of subjects were 65 years of age or older and 63% had PSI scores of IV or V. The mortality data for 30 days, 1 year, and 4-6 years are summarized in the table .

The authors conclude that the long-term mortality following hospitalization for pneumonia correlates strongly with the initial PSI scores. They also suggest enhanced prevention strategies for those with PSI scores of IV and V at admission including closer follow-up based on these observations.

Viewpoint

The author claims that, to his knowledge, this is the largest study of outcomes for hospitalized patients with pneumonia. The correlation between both short- and long-term mortality with the PSI score is quite striking.

Abstract

References

Cite this: Calculating Risks for Complications and Death With CAP - Medscape - Feb 02, 2009.

Table. Short- and Long-term Mortality According to Baseline PSI Score
Score	No. (%)	30-Day Mortality	1-Year Mortality	4- to 6-Year Mortality
I or II	617 (19%)	1%	7%	15%
III	613 (19%)	4%	14%	36%
IV	1306 (40%)	11%	28%	62%
V	748 (23%)	29%	57%	82%

PSI = pneumonia severity index

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