Factors associated with mortality in younger and older (≥75 years) hospitalized patients with community-acquired pneumonia

BACKGROUND: Pneumonia is among the most serious infections in the elderly. The evaluation of prognosis and predicting the outcome is essential in managing the treatment of patients with pneumonia. OBJECTIVES: Evaluate factors that might affect the mortality of elderly patients hospitalized for community-acquired pneumonia (CAP) in two age groups. DESIGN: Medical record review. SETTING: Tertiary care hospital. PATIENTS AND METHODS: The study included CAP patients who were hospitalized during the period from January 2017 and December 2019. The CURB-65 scale was chosen to assess the severity of pneumo- nia on admission. Multivariate analyses were conducted separately for patients younger than 75 years and 75 years or older. MAIN OUTCOME MEASURES: 30-day mortality, factors associated with mortality. SAMPLE SIZE AND CHARACTERISTICS: 1603 patients with a median age of 74, including 918 women (57%). RESULTS: The 30-day mortality rate was 6.5%. Patients with carbapen- em-resistant gram-negative bacteria had lower survival rates (P<.0001). In the multivariate analysis, age, lung cancer, CURB-65, carbapenem resistance, and duration of hospital stay were associated with mortality in patients aged 75 years or older. Lung cancer, malignant disease, car- bapenem resistance, duration of hospital stay and procalcitonin level were associated with mortality under the age of 75. Of 640 sputum cultures tested, P aeruginosa (42%) was the most common pathogen. CONCLUSION: The risk factors that affected mortality differed among patients aged 75 years or older versus younger patients. Our findings are important in determining factors associated with mortality in man- aging the treatment and follow up of hospitalized CAP patients young- er or 75 years of age or older. LIMITATION: Single-center, retrospective.