Long-Term Bedridden Status as a Predictor of in-Hospital Mortality in Older Adults with Community-Acquired Pneumonia: A Retrospective Cohort Study
Abstract
Background Long-term bedridden elderly individuals face a high risk of community-acquired pneumonia (CAP) amid China’s aging population, yet the specific mortality impact remains insufficiently studied. Objective To compare the clinical characteristics and in-hospital mortality between long-term bedridden and ambulatory elderly patients with CAP, and to identify risk factors for mortality. Methods This retrospective study included 453 patients aged ≥75 years hospitalized with CAP from March 2016 to March 2019, divided into a bedridden group (n = 162) and a non-bedridden group (n = 291). Data on demographics, comorbidities, frailty (modified Frailty Index-5, mFI-5), functional status (Barthel Index), and laboratory parameters (eg, hs-CRP) were collected. Logistic regression analysis was used to identify predictors of in-hospital mortality. Results The bedridden group had a significantly higher mortality rate (27.16% vs 2.06%, P < 0.001) and elevated hs-CRP levels (40.2 ± 44.0 mg/L vs 19.9 ± 20.3 mg/L). Multivariate analysis identified bedridden status (OR = 11.99, 95% CI: 4.31–33.40), respiratory failure (OR = 6.80, 95% CI: 3.03–15.28), and renal dysfunction (elevated serum creatinine; OR = 1.01, 95% CI: 1.00–1.02) as independent risk factors for mortality. Conclusion Long-term bedridden status is an independent predictor of in-hospital mortality in elderly CAP patients with inflammatory response potentially playing a critical role.
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: 453 participants or records.
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