Predicting 1-year mortality after hospitalization for community-Acquired pneumonia

Abstract

Background Community-Acquired pneumonia (CAP) is a major public health problem with high shortand long-Term mortality. The main aim of this study was to develop and validate a specific prognostic index for one-year mortality in patients admitted for CAP. Methods This was an observational, prospective study of adults aged 18 years admitted to Galdakao- Usansolo Hospital (Bizkaia, Spain) from January 2001 to July 2009 with a diagnosis of CAP surviving the first 15 days. The entire cohort was divided into two parts, in order to develop a one-year mortality predictive model in the derivation cohort, before validation using the second cohort. Results A total of 2351 patients were included and divided into a derivation and a validation cohort. After deaths within 15 days were excluded, one-year mortality was 10.63%. A predictive model was created in order to predict one-year mortality, with a weighted score that included: Aged over 80 years (4 points), congestive heart failure (2 points), dementia (6 points), respiratory rate 30 breaths per minute (2 points) and blood urea nitrogen >30 mg/dL (3 points) as predictors of higher risk with C-index of 0.76. This new model showed better predictive ability than current risk scores, PSI, CURB65 and SCAP with C-index of 0.73, 0.69 and 0.70, respectively. Conclusions An easy-To-use score, called the one-year CAPSI, may be useful for identifying patients with a high probability of dying after an episode of CAP.