The impact of community-acquired pneumonia on the health-related quality-of-life in elderly.

Abstract

BACKGROUND:

The sustained health-related quality-of-life of patients surviving community-acquired pneumonia has not been accurately quantified. The aim of the current study was to quantify differences in health-related quality-of-life of community-dwelling elderly with and without community-acquired pneumonia during a 12-month follow-up period.

METHODS:

In a matched cohort study design, nested in a prospective randomized double-blind placebo-controlled trial on the efficacy of the 13-valent pneumococcal vaccine in community-dwelling persons of ≥65 years, health-related quality-of-life was assessed in 562 subjects hospitalized with suspected community-acquired pneumonia (i.e. diseased cohort) and 1145 unaffected persons (i.e. non-diseased cohort) matched to pneumonia cases on age, sex, and health status (EQ-5D-3L-index). Health-related quality-of-life was determined 1-2 weeks after hospital discharge/inclusion and 1, 6 and 12 months thereafter, using Euroqol EQ-5D-3L and Short Form-36 Health survey questionnaires. One-year quality-adjusted life years (QALY) were estimated for both diseased and non-diseased cohorts. Separate analyses were performed for pneumonia cases with and without radiologically confirmed community-acquired pneumonia.

RESULTS:

The one-year excess QALY loss attributed to community-acquired pneumonia was 0.13. Mortality in the post-discharge follow-up year was 8.4% in community-acquired pneumonia patients and 1.2% in non-diseased persons (p < 0.001). During follow-up health-related quality-of-life was persistently lower in community-acquired pneumonia patients, compared to non-diseased persons, but differences in health-related quality-of-life between radiologically confirmed and non-confirmed community-acquired pneumonia cases were not statistically significant.

CONCLUSIONS:

Community-acquired pneumonia was associated with a six-fold increased mortality and 16% lower quality-of-life in the post-discharge year among patients surviving hospitalization for community-acquired pneumonia, compared to non-diseased persons.

TRIAL REGISTRATION:

ClinicalTrials.gov, NCT00812084 .

• Authors: Marie-Josée J Mangen, Susanne M Huijts, Marc J M Bonten, G Ardine de Wit
• Journal: BMC infectious diseases (BMC Infect Dis) Vol. 17 Issue 1 Pg. 208 (03 14 2017) ISSN: 1471-2334 [Electronic] England
• PMID: 28292280 (Publication Type: Journal Article)

Topics

• Age Factors
• Aged
• Aged, 80 and over
• Cohort Studies
• Community-Acquired Infections (mortality, psychology)
• Female
• Health Status
• Hospitalization (statistics & numerical data)
• Humans
• Male
• Netherlands (epidemiology)
• Pneumonia (mortality, psychology)
• Quality of Life
• Quality-Adjusted Life Years
• Randomized Controlled Trials as Topic
• Socioeconomic Factors
• Surveys and Questionnaires