Impact of comorbidities on in-hospital mortality of community-acquired pneumonia in elderly patients
10.3760/cma.j.issn.0254-9026.2025.03.012
- VernacularTitle:共病对老年社区获得性肺炎患者院内死亡风险的影响
- Author:
Yanting HAO
1
;
Fan ZHANG
;
Hua ZHANG
;
Fuchun ZHANG
Author Information
1. 北京大学第三医院老年科，北京 100191
- Publication Type:Journal Article
- Keywords:
Community-acquired pneumonia;
Comorbidity;
Influencing factor
- From:
Chinese Journal of Geriatrics
2025;44(3):311-316
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the association between the number and type of comorbidities—specifically high-risk(HR)and at-risk(AR)—and the risk of in-hospital mortality among elderly patients aged 65 years and older with community-acquired pneumonia(CAP).Methods:A retrospective study was conducted to gather basic information, along with diagnostic and treatment data, for elderly CAP patients hospitalized at the Third Hospital of Peking University from January 1, 2010, to December 31, 2019.Binary logistic regression was employed to examine the relationships between both the number and type of coexisting chronic diseases and in-hospital mortality in this patient population.Results:This study included a total of 2 466 elderly patients aged ≥65 years with CAP, of whom 428(17.36%)died during hospitalization.The presence of HR comorbidities was associated with an increased likelihood of in-hospital mortality ( OR=1.81, 95% CI: 1.44-2.28, P<0.001).Similarly, the presence of AR comorbidities was significantly linked to higher in-hospital mortality ( OR=15.72, 95% CI: 7.39-33.42, P<0.001).The risk of mortality escalated with the accumulation of AR comorbidities, with risk ratios ranging from 5.46 to 44.72.Notably, elderly CAP patients with 4 to 5 AR comorbidities in conjunction with HR comorbidities exhibited the highest mortality risk ( OR=85.56, 95% CI: 19.86-368.67, P<0.001).Among the comorbidities assessed, chronic liver disease emerged as the most significant factor associated with mortality in elderly CAP patients, with an importance coefficient of 0.258. Conclusions:In addition to specific comorbidities, the total number of combined comorbidities and the interplay between AR and HR comorbidities may significantly influence the outcomes of hospitalized CAP patients aged 65 years and older.Therefore, it is essential to carefully consider the diagnosis and management of comorbidities in elderly CAP patients to mitigate their risk of mortality.
