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

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Jena University Hospital
  • University Hospital Frankfurt
  • University Hospital Schleswig-Holstein Campus Kiel
  • Charité – Universitätsmedizin Berlin
  • German Center for Lung Research (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

Original languageEnglish
Pages (from-to)621-630
Number of pages10
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
Volume41
Issue number4
Publication statusPublished - Apr 2022
Peer-reviewedYes

External IDs

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

Keywords

Subject groups, research areas, subject areas according to Destatis

Sustainable Development Goals

Keywords

  • 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