Marked Reduction in 30-day Mortality among Elderly Patients with Community-Acquired Pneumonia

摘要: Abstract Background Community-acquired pneumonia is the most common infectious cause of death in US. Over last 2 decades, patient characteristics and clinical care have changed. To understand impact these changes, we quantified incidence mortality trends among elderly adults. Methods We used Medicare claims to identify episodes pneumonia, based on a validated combination diagnosis codes. Comorbidities were ascertained using codes located 1-year look back. Trends site compared. The association between year episode 30-day was then evaluated by logistic regression, with adjustment for age, sex, comorbidities. Results identified 2,654,955 cases from 1987-2005. During this period, proportion treated as inpatients decreased, aged ≥80 years increased, frequency many comorbidities rose. Adjusted increased 3096 per 100,000 population 1999, some decrease thereafter. Age/sex-adjusted decreased 13.5% 9.7%, relative reduction 28.1%. Compared 1987, risk through 2005 (adjusted odds ratio, 0.46; 95% confidence interval, 0.44-0.47). This result robust restriction comorbid diagnoses assessing results' sensitivity coding. Conclusions These findings show marked over time community-acquired patients. hypothesize that pneumococcal influenza vaccination rates well wider use guideline-concordant antibiotics explain large portion trend. © 2011 Elsevier Inc. All rights reserved.