Han Jin H, Resser J Jackson, Baughman Adrienne, Grijalva Carlos G, Johnson Jakea, Miller Karen F, Roberts Craig S, Johnson Kelly D, Weiss Thomas, Self Wesley H
Department of Emergency Medicine, Vanderbilt University Medical Center, 2215 Garland Ave, Light Hall 203, Nashville, TN, 37232-4700, USA.
Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System, Nashville, TN, USA.
BMC Infect Dis. 2025 Jul 1;25(1):826. doi: 10.1186/s12879-025-11186-w.
The long-term morbidity associated with community-acquired pneumonia (CAP) and the risk factors associated with this long-term morbidity are unclear. In adults hospitalized for CAP, we sought to quantify the impact of CAP on loss of function, cognitive impairment, loss of employment, and quality of life six months after hospitalization for CAP and identify risk factors for these adverse outcomes.
This prospective cohort study is an analysis of the Pneumococcal Pneumonia Epidemiology, Urine serotyping, and Mental Outcomes (PNEUMO) study population conducted at an academic, quaternary care hospital. Patients aged ≥ 50 years old and hospitalized for CAP between 2018 and 2020 were included in this analysis. Risk factors, including demographics, pre-illness status, comorbidities, delirium at enrollment, and pneumococcal etiology, were considered. Follow-up was conducted by phone six months after hospitalization for CAP to assess basic and instrumental activities of daily living (ADL), cognition, employment, and quality of life. Proportional odds logistic regression was performed to evaluate the association between potential risk factors and long-term morbidity.
Of the 296 patients included in this analysis, 12.8% lost the ability to perform at least 1 basic ADL, 22.8% lost the ability to perform at least 1 instrumental ADL, 41.6% met criteria for cognitive impairment, 58.7% had a loss of employment, and 23.6% had decreased quality of life at 6-months. Poorer pre-illness ability to perform instrumental ADLs and quality of life, lower education, female sex, former and current tobacco use, past history of dementia, and delirium were associated with worsening 6-month outcomes, with the exception of employment.
Adult patients hospitalized for CAP suffered from significant morbidity at 6 months after discharge. Strategies are needed to prevent or mitigate these adverse outcomes, especially among those at higher risk.
社区获得性肺炎（CAP）相关的长期发病率以及与此长期发病率相关的危险因素尚不清楚。在因CAP住院的成年人中，我们试图量化CAP对住院治疗CAP六个月后功能丧失、认知障碍、失业和生活质量的影响，并确定这些不良结局的危险因素。
这项前瞻性队列研究是对在一家学术性四级医疗医院进行的肺炎球菌肺炎流行病学、尿液血清分型和心理结局（PNEUMO）研究人群的分析。纳入了2018年至2020年间年龄≥50岁且因CAP住院的患者。考虑了危险因素，包括人口统计学、病前状态、合并症、入院时的谵妄以及肺炎球菌病因。在因CAP住院六个月后通过电话进行随访，以评估基本和工具性日常生活活动（ADL）、认知、就业和生活质量。进行比例优势逻辑回归以评估潜在危险因素与长期发病率之间的关联。
在纳入该分析的296例患者中，12.8%失去了至少进行一项基本ADL的能力，22.8%失去了至少进行一项工具性ADL的能力，41.6%符合认知障碍标准，58.7%出现失业，23.6%在六个月时生活质量下降。病前进行工具性ADL的能力和生活质量较差、教育程度较低、女性、既往和当前吸烟、痴呆病史以及谵妄与六个月结局恶化相关，但就业情况除外。
因CAP住院的成年患者在出院后六个月时存在显著的发病率。需要采取策略来预防或减轻这些不良结局，尤其是在高危人群中。
