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Pneumonia's long-term effects comparable to MI

Wednesday March 20, 2013
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The long-term consequences of pneumonia can be more detrimental to a person's health than having a myocardial infarction, according to a study.

Older adults who are hospitalized for pneumonia have a significantly higher risk of new problems that affect their ability to care for themselves, and the effects are comparable to those who survive MI or stroke, reported researchers with the University of Michigan Health System and University of Washington School of Medicine.

“Pneumonia is clearly not only an acute life-threatening event but also a profoundly life-altering event,” Theodore J. Iwashyna, MD, PhD, the study’s senior author and an assistant professor of internal medicine at U-M, said in a news release.

“The potentially substantial chronic care needs and diminished quality of life for survivors are comparable to the effects of heart disease, yet we invest far fewer resources in pneumonia prevention,” added Iwashyna, also of the Institute of Social Research and the VA Center for Clinical Management Research.

Patients who were treated for pneumonia – including those hospitalized even once in a nine-year period and who did not require critical care – were more than twice as likely to develop new cognitive impairments. These new brain problems often led to disability and nursing home admissions among older adults. After treatment for pneumonia, patients also had nearly double the risk of substantial depressive symptoms.

Following hospitalization, patients with pneumonia also had significantly increased risk of losing the ability to maintain daily life activities such as walking, cooking meals or being able to use the bathroom without assistance.

“Even non-critical pneumonia hospitalization can lead to long-term adverse outcomes at a magnitude much greater than we previously thought,” said Dimitry S. Davydow, MD, MPH, assistant professor of psychiatry at U-W. “Pneumonia prevention and interventions are crucial given the costly and detrimental consequences for patients.”

Pneumonia accounts for roughly 390,000 hospitalizations among older adults a year, costing Medicare more than $7.3 billion – and hospitalizations for the condition are expected to double by 2040. Nearly half of pneumonia survivors die within a year.

Prevention methods include improved timeliness and appropriateness of antibiotics, vaccination against influenza and screening older adults for depression following pneumonia.

The study was published March 15 on the website of the Journal of American Medicine. The study abstract is available at www.amjmed.com/article/S0002-9343%2813%2900013-2/abstract.

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