The impact of community-acquired pneumonia on the health-related quality-of-life in elderly

M.-J.J. Mangen, S.M. Huijts, M.J.M. Bonten, G.A. de Wit

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

© 2017 The Author(s).Background: The sustained health-related quality-of-life of patients surviving community-acquired pneumonia has not been accurately quantified. The aim of the current study was to quantify differences in health-related quality-of-life of community-dwelling elderly with and without community-acquired pneumonia during a 12-month follow-up period. Methods: In a matched cohort study design, nested in a prospective randomized double-blind placebo-controlled trial on the efficacy of the 13-valent pneumococcal vaccine in community-dwelling persons of ≥65 years, health-related quality-of-life was assessed in 562 subjects hospitalized with suspected community-acquired pneumonia (i.e. diseased cohort) and 1145 unaffected persons (i.e. non-diseased cohort) matched to pneumonia cases on age, sex, and health status (EQ-5D-3L-index). Health-related quality-of-life was determined 1-2 weeks after hospital discharge/inclusion and 1, 6 and 12 months thereafter, using Euroqol EQ-5D-3L and Short Form-36 Health survey questionnaires. One-year quality-adjusted life years (QALY) were estimated for both diseased and non-diseased cohorts. Separate analyses were performed for pneumonia cases with and without radiologically confirmed community-acquired pneumonia. Results: The one-year excess QALY loss attributed to community-acquired pneumonia was 0.13. Mortality in the post-discharge follow-up year was 8.4% in community-acquired pneumonia patients and 1.2% in non-diseased persons (p < 0.001). During follow-up health-related quality-of-life was persistently lower in community-acquired pneumonia patients, compared to non-diseased persons, but differences in health-related quality-of-life between radiologically confirmed and non-confirmed community-acquired pneumonia cases were not statistically significant. Conclusions: Community-acquired pneumonia was associated with a six-fold increased mortality and 16% lower quality-of-life in the post-discharge year among patients surviving hospitalization for community-acquired pneumonia, compared to non-diseased persons. Trial registration: ClinicalTrials.gov, NCT00812084.
Original languageEnglish
Article number208
JournalBMC Infectious Diseases
Volume17
Issue number1
DOIs
Publication statusPublished - 14 Mar 2017
Externally publishedYes

Funding

The authors would like to thank all “Costs, Health status and Outcomes of community-acquired pneumonia (CAP)” (CHO-CAP) participants for their participation. The “Community-Acquired Pneumonia immunization Trial in Adults” (CAPiTA) team and the CHO-CAP-team from Julius Clinical B.V. in Zeist are acknowledged for their logistic support during the data collection. The CHO-CAP study is made possible by an unrestricted grant from Wyeth Pharmaceuticals, which was acquired by Pfizer Inc. in October 2009, to the University Medical Centre Utrecht. Bonten reports receipt of research funding from Pfizer, and service on the CAPiTA European Expert Meeting. Huijts reports receipt of financial support for printing her PhD thesis from Pfizer. De Wit reports receipt of unrestricted research grant from Pfizer paid to UMCU. Huijts and Mangen’s research funding is partially supported by these grants provided to UMCU by Pfizer. Bonten, Huijts, Mangen, and de Wit are UMCU employees. No other disclosures were reported. The CHO-CAP study is made possible by an unrestricted grant from Wyeth Pharmaceuticals, which was acquired by Pfizer Inc. in October 2009, to the University of Medical Centre of Utrecht.

FundersFunder number
CAPiTA European Expert Meeting
UMCU
University Medical Centre Utrecht
University of Medical Centre of Utrecht
Pfizer
Wyeth Pharmaceuticals

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