Risk factors for 30-day mortality in elderly patients with lower respiratory tract infection. Community-based study

Arch Intern Med. 1997 Oct 27;157(19):2190-5.


Background: Pneumonia is a major cause of death in the elderly, but there are few studies of risk factors for death that include both ambulatory and nursing home patients.

Objective: To assess factors associated with 30-day mortality in a population-based study of older adults with lower respiratory tract infection.

Methods: Identification of (1) a previously identified retrospective cohort of all residents of Rochester, Minn, aged 65 years or older who experienced a first episode of pneumonia or bronchitis during a calendar year and (2) the risk factors associated with 30-day mortality through review of complete inpatient and ambulatory medical records. Logistic regression was used to identify significant independent risk factors for 30-day mortality.

Results: A total of 413 adults aged 65 years or older were identified. The independent factors for 30-day mortality were atypical symptoms (odds ratio [OR], 4.98; 95% confidence interval [CI], 2.14-11.60), neurologic illness (OR, 3.92; 95% CI, 1.47-6.59), current diagnosis of cancer (OR, 6.2; 95% CI, 2.40-15.99), and recent or current use of antibiotics (OR, 3.13; 95% CI, 1.45-6.77).

Conclusions: Malignancy and neurologic disease are well-recognized conditions that identify patients with lower respiratory tract infections who have a high risk of death within 30 days. An atypical presentation with confusion, lethargy, poor eating, or recent or current antibiotic use also identifies patients, with a high risk of 30-day mortality.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Community-Acquired Infections / etiology
  • Community-Acquired Infections / mortality
  • Female
  • Humans
  • Male
  • Odds Ratio
  • Pneumonia / complications
  • Pneumonia / diagnosis
  • Pneumonia / etiology*
  • Pneumonia / mortality*
  • Predictive Value of Tests
  • Retrospective Studies
  • Risk Factors