The Burden of Community-acquired Pneumonia in the Elderly: the Spanish EVAN-65 Study

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2008 Jun 28

PMID 18582392

Citations 45

Authors

Olga Ochoa-Gondar

Angel Vila-Corcoles

Cinta de Diego

Victoria Arija

Monica Maxenchs

Montserrat Grive

Enrique Martin

Josep L Pinyol

Affiliations

Soon will be listed here.

Abstract

Background: Community-acquired pneumonia (CAP) is generally considered a major cause of morbidity and mortality in the elderly. However, population-based data are very limited and its overall burden is unclear. This study assessed incidence and mortality from CAP among Spanish community-dwelling elderly.

Methods: Prospective cohort study that included 11,240 individuals aged 65 years or older, who were followed from January 2002 until April 2005. Primary endpoints were all-cause CAP (hospitalised and outpatient) and 30-day mortality after the diagnosis. All cases were radiographically proved and validated by checking clinical records.

Results: Incidence rate of overall CAP was 14 cases per 1,000 person-year (95% confidence interval: 12.7 to 15.3). Incidence increased dramatically by age (9.9 in people 65-74 years vs 29.4 in people 85 years or older), and it was almost double in men than in women (19.3 vs 10.1). Hospitalisation rate was 75.1%, with a mean length-stay of 10.4 days. Overall 30-days case-fatality rate was 13% (15% in hospitalised and 2% in outpatient cases).

Conclusion: CAP remains as a major health problem in older adults. Incidence rates in this study are comparable with rates described in Northern Europe and America, but they largely doubled prior rates reported in other Southern European regions.

Citing Articles

Organizational Benefits of Ultra-Low-Dose Chest CT Compared to Chest Radiography in the Emergency Department for the Diagnostic Workup of Community-Acquired Pneumonia: A Real-Life Retrospective Analysis.

Kepka S, Heimann C, Severac F, Hoffbeck L, Le Borgne P, Bayle E Medicina (Kaunas). 2023; 59(9).

PMID: 37763627 PMC: 10532772. DOI: 10.3390/medicina59091508.

Diagnostic and Prognostic Roles of Procalcitonin and Other Tools in Community-Acquired Pneumonia: A Narrative Review.

Ozbay S, Ayan M, Ozsoy O, Akman C, Karcioglu O Diagnostics (Basel). 2023; 13(11).

PMID: 37296721 PMC: 10253144. DOI: 10.3390/diagnostics13111869.

Association between anticholinergic medication uses and the risk of pneumonia in elderly adults: a meta-analysis and systematic review.

Wu M, Li Z, Zheng W, Zhuang J, Wu S, Zhou Q Ann Med. 2023; 55(1):2209736.

PMID: 37190776 PMC: 10190193. DOI: 10.1080/07853890.2023.2209736.

Using the Oral Assessment Guide to Predict the Onset of Pneumonia in Residents of Long-Term Care and Welfare Facilities: A One-Year Prospective Cohort Study.

Yamanaka M, Yamaguchi K, Muramatsu M, Miura H, Ochi M Int J Environ Res Public Health. 2022; 19(21).

PMID: 36360610 PMC: 9654310. DOI: 10.3390/ijerph192113731.

Deciphering the Mechanism of YuPingFeng Granules in Treating Pneumonia: A Network Pharmacology and Molecular Docking Study.

Huang B, Luo J, Liu L, Deng W, Wang K, Lu H Evid Based Complement Alternat Med. 2022; 2022:4161235.

PMID: 36285159 PMC: 9588365. DOI: 10.1155/2022/4161235.

References

Woodhead M, Macfarlane J, McCracken J, Rose D, Finch R . Prospective study of the aetiology and outcome of pneumonia in the community. Lancet. 1987; 1(8534):671-4. DOI: 10.1016/s0140-6736(87)90430-2. View

Macfarlane J, Colville A, Guion A, Macfarlane R, Rose D . Prospective study of aetiology and outcome of adult lower-respiratory-tract infections in the community. Lancet. 1993; 341(8844):511-4. DOI: 10.1016/0140-6736(93)90275-l. View

Vila-Corcoles A, Ochoa-Gondar O, Llor C, Hospital I, Rodriguez T, Gomez A . Protective effect of pneumococcal vaccine against death by pneumonia in elderly subjects. Eur Respir J. 2005; 26(6):1086-91. DOI: 10.1183/09031936.05.00030205. View

Jackson M, Neuzil K, Thompson W, Shay D, Yu O, Hanson C . The burden of community-acquired pneumonia in seniors: results of a population-based study. Clin Infect Dis. 2004; 39(11):1642-50. PMC: 7108010. DOI: 10.1086/425615. View

Gutierrez F, Masia M, Mirete C, Soldan B, Carlos Rodriguez J, Padilla S . The influence of age and gender on the population-based incidence of community-acquired pneumonia caused by different microbial pathogens. J Infect. 2005; 53(3):166-74. DOI: 10.1016/j.jinf.2005.11.006. View

Marrie T . Community-acquired pneumonia in the elderly. Clin Infect Dis. 2000; 31(4):1066-78. DOI: 10.1086/318124. View

Santos de Unamuno C, Llorente San Martin M, Carandell Jager E, Gutierrez Garcia M, Riera Jaume M, Ramirez Rosales A . [Site of care provision, etiology and treatment of community-acquired pneumonia in Palma de Mallorca]. Med Clin (Barc). 1998; 110(8):290-4. View

Markowitz J, Pashko S, Gutterman E, Newbold 3rd R . Death rates among patients hospitalized with community-acquired pneumonia: a reexamination with data from three states. Am J Public Health. 1996; 86(8):1152-4. PMC: 1380630. DOI: 10.2105/ajph.86.8_pt_1.1152. View

Loeb M . Pneumonia in older persons. Clin Infect Dis. 2003; 37(10):1335-9. DOI: 10.1086/379076. View

10.

Houston M, Silverstein M, Suman V . Community-acquired lower respiratory tract infection in the elderly: a community-based study of incidence and outcome. J Am Board Fam Pract. 1995; 8(5):347-56. View

11.

Jokinen C, Heiskanen L, Juvonen H, Kallinen S, Karkola K, Korppi M . Incidence of community-acquired pneumonia in the population of four municipalities in eastern Finland. Am J Epidemiol. 1993; 137(9):977-88. DOI: 10.1093/oxfordjournals.aje.a116770. View

12.

Zalacain R, Torres A, Celis R, Blanquer J, Aspa J, Esteban L . Community-acquired pneumonia in the elderly: Spanish multicentre study. Eur Respir J. 2003; 21(2):294-302. DOI: 10.1183/09031936.03.00064102. View

13.

Feldman C . Pneumonia in the elderly. Clin Chest Med. 1999; 20(3):563-73. DOI: 10.1016/s0272-5231(05)70236-7. View

14.

Fine M, Auble T, Yealy D, Hanusa B, Weissfeld L, Singer D . A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med. 1997; 336(4):243-50. DOI: 10.1056/NEJM199701233360402. View

15.

Bochud P, Moser F, Erard P, Verdon F, Studer J, Villard G . Community-acquired pneumonia. A prospective outpatient study. Medicine (Baltimore). 2001; 80(2):75-87. DOI: 10.1097/00005792-200103000-00001. View

16.

Ortqvist A, Hedlund J, Grillner L, Jalonen E, Kallings I, Leinonen M . Aetiology, outcome and prognostic factors in community-acquired pneumonia requiring hospitalization. Eur Respir J. 1990; 3(10):1105-13. View

17.

Mandell L, Bartlett J, Dowell S, File Jr T, Musher D, Whitney C . Update of practice guidelines for the management of community-acquired pneumonia in immunocompetent adults. Clin Infect Dis. 2003; 37(11):1405-33. PMC: 7199894. DOI: 10.1086/380488. View

18.

Fernandez-Sabe N, Carratala J, Roson B, Dorca J, Verdaguer R, Manresa F . Community-acquired pneumonia in very elderly patients: causative organisms, clinical characteristics, and outcomes. Medicine (Baltimore). 2003; 82(3):159-69. DOI: 10.1097/01.md.0000076005.64510.87. View

19.

Fine M, Smith M, Carson C, Mutha S, Sankey S, Weissfeld L . Prognosis and outcomes of patients with community-acquired pneumonia. A meta-analysis. JAMA. 1996; 275(2):134-41. View

20.

Marston B, Plouffe J, File Jr T, Hackman B, Salstrom S, Lipman H . Incidence of community-acquired pneumonia requiring hospitalization. Results of a population-based active surveillance Study in Ohio. The Community-Based Pneumonia Incidence Study Group. Arch Intern Med. 1997; 157(15):1709-18. View