Early post-discharge mortality in CAP: frequency, risk factors and a prediction tool

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Universitätsklinikum Jena
  • Universitätsklinikum Frankfurt
  • Universitätsklinikum Schleswig-Holstein Campus Kiel
  • Charité – Universitätsmedizin Berlin
  • Deutsche Zentrum für Lungenforschung (DZL)

Abstract

There are few data on mortality after discharge with community-acquired pneumonia (CAP). Therefore, we evaluated risk factors for 30-day post-discharge mortality after CAP. We included all patients of the prospective multi-national CAPNETZ study between 2002 and 2018 with (1) hospitalized CAP, (2) survival until discharge, and (3) complete follow-up data. The study endpoint was death within 30 days after discharge. We evaluated risk factors including demographics, comorbidities, admission CAP severity, and laboratory values and treatment-related factors in uni- and multivariable analyses. A total of 126 (1.6%) of 7882 included patients died until day 30 after discharge, corresponding to 26% of all 476 deaths. After multivariable analysis, we identified 10 independent risk factors: higher age, lower BMI, presence of diabetes mellitus, chronic renal or chronic neurological disease (other than cerebrovascular diseases), low body temperature or higher thrombocytes on admission, extended length of hospitalization, oxygen therapy during hospitalization, and post-obstructive pneumonia. By addition these factors, we calculated a risk score with an AUC of 0.831 (95%CI 0.822-0.839, p < 0.001) for prediction of post-discharge mortality. Early post-discharge deaths account for ¼ of all CAP-associated deaths and are associated with patient- and CAP-severity-related risk factors. Additional studies are necessary to replicate our findings in independent cohorts. Study registration: NCT02139163.

Details

OriginalspracheEnglisch
Seiten (von - bis)621-630
Seitenumfang10
FachzeitschriftEuropean Journal of Clinical Microbiology and Infectious Diseases
Jahrgang41
Ausgabenummer4
PublikationsstatusVeröffentlicht - Apr. 2022
Peer-Review-StatusJa

Externe IDs

PubMedCentral PMC8934328
ORCID /0000-0001-6022-6827/work/127318519
Scopus 85124335733
WOS 000752834400002
Mendeley ea3c0bbb-5c20-34f0-9899-3522af6b605a

Schlagworte

Fächergruppen, Lehr- und Forschungsbereiche, Fachgebiete nach Destatis

Ziele für nachhaltige Entwicklung

Schlagwörter

  • Aftercare, Community-Acquired Infections, Hospitalization, Humans, Patient Discharge, Pneumonia/epidemiology, Prognosis, Prospective Studies, Risk Factors, Severity of Illness Index, Post-discharge, Mortality, Community-acquired pneumonia