The impact of community-acquired pneumonia on the health-related quality-of-life in elderly

BMC Infect Dis. 2017 Mar 14;17(1):208. doi: 10.1186/s12879-017-2302-3.


Background: The sustained health-related quality-of-life of patients surviving community-acquired pneumonia has not been accurately quantified. The aim of the current study was to quantify differences in health-related quality-of-life of community-dwelling elderly with and without community-acquired pneumonia during a 12-month follow-up period.

Methods: In a matched cohort study design, nested in a prospective randomized double-blind placebo-controlled trial on the efficacy of the 13-valent pneumococcal vaccine in community-dwelling persons of ≥65 years, health-related quality-of-life was assessed in 562 subjects hospitalized with suspected community-acquired pneumonia (i.e. diseased cohort) and 1145 unaffected persons (i.e. non-diseased cohort) matched to pneumonia cases on age, sex, and health status (EQ-5D-3L-index). Health-related quality-of-life was determined 1-2 weeks after hospital discharge/inclusion and 1, 6 and 12 months thereafter, using Euroqol EQ-5D-3L and Short Form-36 Health survey questionnaires. One-year quality-adjusted life years (QALY) were estimated for both diseased and non-diseased cohorts. Separate analyses were performed for pneumonia cases with and without radiologically confirmed community-acquired pneumonia.

Results: The one-year excess QALY loss attributed to community-acquired pneumonia was 0.13. Mortality in the post-discharge follow-up year was 8.4% in community-acquired pneumonia patients and 1.2% in non-diseased persons (p < 0.001). During follow-up health-related quality-of-life was persistently lower in community-acquired pneumonia patients, compared to non-diseased persons, but differences in health-related quality-of-life between radiologically confirmed and non-confirmed community-acquired pneumonia cases were not statistically significant.

Conclusions: Community-acquired pneumonia was associated with a six-fold increased mortality and 16% lower quality-of-life in the post-discharge year among patients surviving hospitalization for community-acquired pneumonia, compared to non-diseased persons.

Trial registration:, NCT00812084 .

Keywords: Community-acquired pneumonia; Elderly; Follow-up; Mortality; Quality-of-life.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Community-Acquired Infections / mortality
  • Community-Acquired Infections / psychology*
  • Female
  • Health Status
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Netherlands / epidemiology
  • Pneumonia / mortality
  • Pneumonia / psychology*
  • Quality of Life*
  • Quality-Adjusted Life Years
  • Randomized Controlled Trials as Topic
  • Socioeconomic Factors
  • Surveys and Questionnaires

Associated data