Older Adults Hospitalized for Pneumonia in the United States: Incidence, Epidemiology, and Outcomes

Objectives To define the current incidence, epidemiology, and mortality of older adult patients hospitalized with community-acquired pneumonia (CAP) in Louisville, KY and thus estimate the burden of CAP in the older adult population of the United States. To define risk factors associated with early and late outcomes. Design This was a secondary analysis of older adults (aged ≥65 years) from the University of Louisville Pneumonia Study, a prospective population-based cohort study of all hospitalized adults with CAP between June 1, 2014, and May 31, 2016. Setting The study took place in all nine acute care hospitals for adults in Louisville, KY. Participants Residents in the city of Louisville, KY, who were diagnosed with CAP between the inclusion dates were included and who were aged 65 years or older. Measurements Incidence of CAP and outcomes were measured. A total of nine risk factors were also assessed for any potential association with time to clinical stability, length of stay (LOS), and mortality. Results During the 2-year study, from a Louisville population of 102 264 adults aged 65 years or older, 4760 were hospitalized with CAP. The incidence of older adults hospitalized with CAP was 2093 per 100 000 population. This corresponds to 967 470 older adults in the United States hospitalized per year with CAP. The median time to clinical stability was 2 days, and the median LOS was 6 days. The 30-day all-cause mortality was 17%. The 1-year all-cause mortality was 38% (829 patients), which corresponds to 361 982 deaths in the United States with CAP in older adults. Conclusion The estimated burden of CAP in older adults is substantial in the United States. Nearly 1 million older adults are hospitalized for CAP, and over a third of those die within 1 year. J Am Geriatr Soc 68:1007-1014, 2020.