Comorbidities and their impact on in-hospital mortality in hospitalized adult patients with bacterial community-acquired pneumonia: a cohort study
Abstract
Background As a leading global health burden, community-acquired pneumonia (CAP) continues to account for substantial morbidity and mortality, particularly among patients with pre-existing comorbidities. This study investigated the prognostic impact of comorbidities on in-hospital mortality in adult patients with bacterial CAP. Methods Secondary diagnoses were considered comorbidities if present at admission and reflective of chronic conditions. Multidimensional comorbidity assessment included: Charlson Comorbidity Index (CCI), Elixhauser Comorbidity Index (ECI), condition counts of comorbidities in the Charlson list and Elixhauser list, and binary variable for every medical condition including the comorbidities in the Charlson list and Elixhauser list, every Clinical Classifications Software Refined (CCSR) category, International Statistical Classification of Diseases and Related Health Problems-10th Revision (ICD-10) chapter, block, category, and subcategory. Univariate and multivariate logistic regression analyses were used to evaluate the relationship between comorbidity and in-hospital mortality of CAP. Using split-sample validation, prediction models for in-hospital mortality were developed on a randomly selected derivation cohort (60%), with performance metrics rigorously assessed on an independent validation cohort (40%). Results Of the total of 11,164 patients, 380 (3.40%) died in the hospital. The most frequent comorbidities in the Charlson and Elixhauser lists are…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 11,164 participants or records.
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