Factors affecting short and long-term mortality after community-acquired pneumonia

Introduction:We evaluated mortality rate and factors related to short(30 days) and long term mortality of community-acquired pneumonia(CAP). Methods: Patients registered to “Pneumonia Data Base,TURCAP” that prepared by Turkish Thoracic Society Respiratory Infections Scientific Assembly between January 2009-2013 were included. Characteristics and clinical-laboratory findings, pneumonia indices were obtained. All cause mortality was recorded. Results: Of the 785 patients,68% were male, and the mean age was 66±16 years. The median follow-up was 38 months, With respect to all-cause mortality,71(9%) patients had died within 30 days, 29,6% within 1 year,349(44%) by study end. Median survival time was 51 months. Short-term mortality was higher in;older age, initial symptoms of chest pain, impaired consciousness, malignancy, serebrovascular diseases, high blood urea nitrogen level, low hematocrit level;parapneumonic effusion and abscess (compared to pneumonia) and extended infiltration,PSI and CURB-65 scores. In multivariate analysis;PSI scores and comorbid diseases were independent factors. For long term mortality, other than short term factors(except extended infiltration);male gender,presence of fever, chronic heart and renal failure, >2 hospitalisation in last 2 months, steroid/immunosuppresive therapy in last 3 months were found to related. Independent factors were PSI score,malignancy,frequent hospitalisation in the last 2 months and low hematocrit levels. Conclusion: Malignancy and PSI scores were the strongest predictors of short and long term mortality,whereas lower hematocrit levels and previous frequent hospitalisation were also strong long term mortality predictors.