Adverse outcomes in patients hospitalized with pneumonia at age 60 or more: A prospective multi-centric hospital-based study in India

• DOI: 10.1371/journal.pone.0297452
• Publication Date: 2024-05-02T17:27:41Z
• Authors: Suman Kanungo; Uttaran Bhattacha...; Aslesh O. Prabhak...; Rakesh Kumar; Prabu Rajkumar; Sumit Dutt Bhardwaj; Alok Kumar Chakra...; Girish Kumar C. P.; Varsha Potdar; Byomkesh Manna; Ritvik Amarchand; Avinash Choudekar; Giridara Gopal; Krishna Sarda; Kathryn E. Lafond; Eduardo Azziz-Bau...; Siddhartha Saha; Lalit Dar; Anand Krishnan
• Keywords: Male; Aged, 80 and over; Science; Q; R; India; Pneumonia; Middle Aged; Hospitalization; Community-Acquired Infections; Intensive Care Units; Risk Factors; Medicine; Humans; Female; Prospective Studies; Hospital Mortality; Research Article; Aged

Background Limited data exists regarding risk factors for adverse outcomes in older adults hospitalized with Community-Acquired Pneumonia (CAP) low- and middle-income countries such as India. This multisite study aimed to assess associated among aged ≥60 years pneumonia. Methods Between December 2018 March 2020, we enrolled ≥60-year-old admitted within 48 hours CAP treatment across 16 public private facilities four sites. Clinical nasal/oropharyngeal specimens were collected by trained nurses tested influenza, respiratory syncytial virus (RSV), other viruses (ORV) using the qPCR. Participants evaluated regularly until discharge, well on 7th 30th days post-discharge. Outcomes included ICU admission in-hospital or 30-day post-discharge mortality. A hierarchical framework multivariable logistic regression Cox proportional hazard models identified (e.g., demographics, clinical features, etiologic agents) critical care death. Findings Of 1,090 patients, median age was 69 years; 38.4% female. Influenza detected 12.3%, RSV 2.2%, ORV 6.3% of participants. Critical required 39.4%, 9.9% mortality 5% Only 41% influenza patients received antiviral treatment. Admission independently rate >30/min, blood urea nitrogen>19mg/dl, altered sensorium, anemia, oxygen saturation <90%, prior cardiovascular diseases, chronic hospital admission. Diabetes, low at admission, mechanical ventilation Conclusion High rates observed pneumonia, a significant proportion linked infections. Comprehensive guidelines prevention management are needed, especially co-circulation SARS-CoV-2.