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Hospitalized community-acquired pneumonia in the elderly: an Australian case-cohort study

Skull, Susan A., Andrews, Ross M., Byrnes, Graham B., Campbell, Donald A., Kelly, H. A., Brown, G. V. and Nolan, T. M. (2009). Hospitalized community-acquired pneumonia in the elderly: an Australian case-cohort study. Epidemiology and infection,137(2):194-202.

Document type: Journal Article
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IRMA ID 10619xPUB18
Title Hospitalized community-acquired pneumonia in the elderly: an Australian case-cohort study
Author Skull, Susan A.
Andrews, Ross M.
Byrnes, Graham B.
Campbell, Donald A.
Kelly, H. A.
Brown, G. V.
Nolan, T. M.
Journal Name Epidemiology and infection
Publication Date 2009
Volume Number 137
Issue Number 2
ISSN 0950-2688   (check CDU catalogue open catalogue search in new window)
Start Page 194
End Page 202
Total Pages 9
Place of Publication Cambridge, U.K.
Publisher Cambridge University Press
HERDC Category C1 - Journal Article (DEST)
Abstract This study describes the epidemiology of community-acquired pneumonia (CAP) in elderly Australians for the first time. Using a case-cohort design, cases with CAP were in-patients aged > or = 65 years with ICD-10-AM codes J10-J18 admitted over 2 years to two tertiary hospitals. The cohort sample was randomly selected from all hospital discharges, frequency-matched to cases by month. Logistic regression was used to estimate risk ratios for factors predicting CAP or associated mortality. A total of 4772 in-patients were studied. There were 1952 cases with CAP that represented 4% of all elderly admissions: mean length of stay was 9.0 days and 30-day mortality was 18%. Excluding chest radiograph, 520/1864 (28%) cases had no investigations performed. The strongest predictors of CAP were previous pneumonia, history of other respiratory disease, and aspiration. Intensive-care-unit admission, renal disease and increasing age were the strongest predictors of mortality, while influenza vaccination conferred protection. Hospitalization with CAP in the elderly is common, frequently fatal and a considerable burden to the Australian community. Investigation is ad hoc and management empirical. Influenza vaccination is associated with reduced mortality. Patient characteristics can predict risk of CAP and subsequent mortality.
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