Tags

Type your tag names separated by a space and hit enter

Characteristics and outcomes of older adults with community-acquired pneumococcal bacteremia.
J Am Geriatr Soc. 2006 Jan; 54(1):115-20.JA

Abstract

OBJECTIVES

To describe baseline characteristics and clinical outcomes of older adults with pneumococcal bacteremia, compare the frequency of serious outcomes according to pneumococcal vaccination status, and assess factors associated with mortality.

DESIGN

Population-based case-series.

SETTING

Group Health Cooperative, a health maintenance organization in Washington State.

PARTICIPANTS

Community-dwelling adults aged 65 and older with a first episode of pneumococcal bacteremia between 1988 and 2002.

MEASUREMENTS

Demographic characteristics, underlying medical conditions, vaccination status, and clinical outcomes, including death, hospitalization, length of hospital stay, and postdischarge care, were assessed using chart review.

RESULTS

The mean age of the 200 elderly patients with pneumococcal bacteremia was 78; 61% were female. Forty percent had had chart-documented pneumococcal vaccination before the onset of bacteremia. The spectrum of clinical severity and consequences was broad. Ten percent were treated as outpatients. Of the 90% who were hospitalized, 16% were admitted to the intensive care unit. All-cause mortality at 30 days was 11%. Of survivors, 23% were discharged with home services, and another 20% were discharged to a nursing home. After controlling for age, sex, and pneumococcal vaccination status, predictors of death included coronary artery disease (odds ratio (OR)=4.6, 95% confidence interval (CI)=1.4-14.5) and immunocompromising conditions (OR=5.0, 95% CI=1.6-15.7). Outcomes were similar in patients who did and did not receive pneumococcal vaccination.

CONCLUSION

In this elderly group, pneumococcal bacteremia was associated with substantial morbidity, mortality, and loss of independence. Coronary artery disease and immunocompromising conditions were independent predictors of death.

Authors+Show Affiliations

Division of Gerontology and Geriatric Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, Washington, USA. rchi@u.washington.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

16420207

Citation

Chi, Ru-Chien, et al. "Characteristics and Outcomes of Older Adults With Community-acquired Pneumococcal Bacteremia." Journal of the American Geriatrics Society, vol. 54, no. 1, 2006, pp. 115-20.
Chi RC, Jackson LA, Neuzil KM. Characteristics and outcomes of older adults with community-acquired pneumococcal bacteremia. J Am Geriatr Soc. 2006;54(1):115-20.
Chi, R. C., Jackson, L. A., & Neuzil, K. M. (2006). Characteristics and outcomes of older adults with community-acquired pneumococcal bacteremia. Journal of the American Geriatrics Society, 54(1), 115-20.
Chi RC, Jackson LA, Neuzil KM. Characteristics and Outcomes of Older Adults With Community-acquired Pneumococcal Bacteremia. J Am Geriatr Soc. 2006;54(1):115-20. PubMed PMID: 16420207.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics and outcomes of older adults with community-acquired pneumococcal bacteremia. AU - Chi,Ru-Chien, AU - Jackson,Lisa A, AU - Neuzil,Kathleen M, PY - 2006/1/20/pubmed PY - 2006/4/8/medline PY - 2006/1/20/entrez SP - 115 EP - 20 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 54 IS - 1 N2 - OBJECTIVES: To describe baseline characteristics and clinical outcomes of older adults with pneumococcal bacteremia, compare the frequency of serious outcomes according to pneumococcal vaccination status, and assess factors associated with mortality. DESIGN: Population-based case-series. SETTING: Group Health Cooperative, a health maintenance organization in Washington State. PARTICIPANTS: Community-dwelling adults aged 65 and older with a first episode of pneumococcal bacteremia between 1988 and 2002. MEASUREMENTS: Demographic characteristics, underlying medical conditions, vaccination status, and clinical outcomes, including death, hospitalization, length of hospital stay, and postdischarge care, were assessed using chart review. RESULTS: The mean age of the 200 elderly patients with pneumococcal bacteremia was 78; 61% were female. Forty percent had had chart-documented pneumococcal vaccination before the onset of bacteremia. The spectrum of clinical severity and consequences was broad. Ten percent were treated as outpatients. Of the 90% who were hospitalized, 16% were admitted to the intensive care unit. All-cause mortality at 30 days was 11%. Of survivors, 23% were discharged with home services, and another 20% were discharged to a nursing home. After controlling for age, sex, and pneumococcal vaccination status, predictors of death included coronary artery disease (odds ratio (OR)=4.6, 95% confidence interval (CI)=1.4-14.5) and immunocompromising conditions (OR=5.0, 95% CI=1.6-15.7). Outcomes were similar in patients who did and did not receive pneumococcal vaccination. CONCLUSION: In this elderly group, pneumococcal bacteremia was associated with substantial morbidity, mortality, and loss of independence. Coronary artery disease and immunocompromising conditions were independent predictors of death. SN - 0002-8614 UR - https://www.unboundmedicine.com/medline/citation/16420207/Characteristics_and_outcomes_of_older_adults_with_community_acquired_pneumococcal_bacteremia_ L2 - https://doi.org/10.1111/j.1532-5415.2005.00528.x DB - PRIME DP - Unbound Medicine ER -