Wyrwich Kathleen W, Yu Holly, Sato Reiko, Powers John H
Evidera, Inc., Bethesda, MD, USA.
Pfizer Inc., Collegeville, PA, USA.
Patient Relat Outcome Meas. 2015 Jul 30;6:215-23. doi: 10.2147/PROM.S85779. eCollection 2015.
Millions of older adults who develop community-acquired pneumonia (CAP) each year survive, but there is a large knowledge gap on the burden of CAP and the recovery process in survivors from the patient perspective.
The newly developed CAP Burden of Illness Questionnaire was administered through a Web survey to a nationwide sample of US adults aged ≥50 years who were recently diagnosed with CAP. Survey respondents with unresolved symptoms or other CAP-related health problems completed a second survey 30 days later; a third survey was completed another 30 days later by respondents with unresolved symptoms or problems. Nationally representative results describing the average time to recovery of symptoms and other CAP-related problems were achieved using post-stratification weights.
Five hundred participants completed the initial survey. The time to resolution for the CAP symptoms of weakness, shortness of breath, and tiredness exceeded 3 weeks on average. There was an average of 13 days of absenteeism, and 3 weeks (mean =21 days) before achieving full work/activity productivity after CAP. For participants with health conditions that worsened from pneumonia, chronic emphysema and chronic obstructive pulmonary disease took the longest to return to baseline (mean =60 and 52.4 days, respectively).
The results from this study demonstrate that older adults surviving a CAP episode experience a significant multi-symptom illness with long recovery periods to achieve pre-CAP health and productivity. These findings highlight the need for further research on effective clinician-patient communication, the need for patient-centered outcomes in clinical trials for CAP therapeutics, adequate home care during the recovery process, and the pursuit of CAP prevention strategies.
每年有数百万患社区获得性肺炎（CAP）的老年人存活下来，但从患者角度来看，关于CAP的负担以及幸存者的康复过程，仍存在巨大的知识空白。
通过网络调查，向全国范围内年龄≥50岁且最近被诊断为CAP的美国成年人样本发放新开发的CAP疾病负担问卷。有未解决症状或其他与CAP相关健康问题的调查受访者在30天后完成第二次调查；有未解决症状或问题的受访者在再过30天后完成第三次调查。使用事后分层权重得出描述症状及其他与CAP相关问题平均恢复时间的全国代表性结果。
500名参与者完成了初始调查。虚弱、呼吸急促和疲劳等CAP症状的缓解时间平均超过3周。平均旷工13天，CAP后平均需要3周（平均=21天）才能恢复到完全的工作/活动能力。对于因肺炎导致健康状况恶化的参与者，慢性肺气肿和慢性阻塞性肺疾病恢复到基线所需时间最长（分别平均为60天和52.4天）。
本研究结果表明，CAP发作后存活的老年人经历了一种多症状的严重疾病，恢复到CAP前的健康和能力水平需要很长时间。这些发现凸显了进一步研究有效医患沟通的必要性、CAP治疗临床试验中以患者为中心结局的必要性、康复过程中充足家庭护理的必要性以及CAP预防策略的必要性。
