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Presentation: 5:39

Poster attached as supplemental file below


Community-acquired pneumonia (CAP) is a major cause of hospitalizations and mortality worldwide. Despite advancements in understanding short-term mortality predictors, identifying factors associated with long-term mortality remains critical for improving patient outcomes. The aim of this study is to summarize the risk factors associated with long-term mortality (>1 year) in previously hospitalized CAP patients. A rapid systematic review was conducted following PRISMA guidelines. PubMed and SCOPUS were searched for studies published from 2011 to 2023. Articles reporting risk factors for long-term mortality in hospitalized adults (>18 years) with CAP were included. The review identified 11 studies reporting on risk predictors for long-term mortality in CAP patients. Blood (RDW, hepcidin), Cardiovascular (cTnT, NT-proBNP, ProADM, ProANP, TMAO), Renal (urea), and Lung specific inflammatory (YKL-40, CCL18, SP-D) biomarkers emerged as significant predictors of CAP. Age and high pneumonia severity scores (PSI/CURB-65), previously used to assess short-term mortality in CAP, are also significantly associated with long-term mortality. Furthermore, integrating biomarkers with severity scores significantly improved mortality prediction models, as evidenced by increased area under the curve (AUC) values. Comorbidities such as chronic obstructive pulmonary disease (COPD), diabetes, liver disease and neoplastic conditions showed high hazard ratios, making them important risk factors for predicting long-term mortality and guiding comprehensive patient management. This review underscores the multifactorial nature of long-term mortality prediction in CAP, emphasizing the necessity of comprehensive patient assessment and tailored treatment strategies. Combining biomarkers with severity scores significantly enhanced prognosis accuracy in CAP patients, indicating the potential for refining prognostic tools in clinical decision-making. Further research is necessary to validate these findings and explore interventions targeting identified risk factors to reduce long-term mortality in CAP patients.

Lay Summary

Community-acquired pneumonia (CAP) is a severe lung infection that can lead to hospitalization and even death, especially among older adults. This study conducted a comprehensive review of research from 2011 to 2023 to identify factors that predict long-term mortality in people hospitalized with CAP. To do that, we searched two database using words related to our question such as, “Community-acquired pneumonia”, “long-term mortality”, “Risk predictors”. We came up with 908 potentially relevant papers. We browsed these papers and found eleven that matched our research question. The review found that elevated levels of specific biomarkers found in the blood, related to heart, lung, and kidney health, were important predictors. Combining these biomarkers with existing severity scoring systems improved the accuracy of predicting who might be at risk of dying in the long term after experiencing CAP. Additionally, certain health conditions like chronic obstructive pulmonary disease (COPD), liver disease, and diabetes, cancer as well as increased age, were significant predictors of long-term mortality. Understanding these risk factors can help healthcare providers identify patients who may need extra care and support after being hospitalized for CAP. By recognizing these factors early on, doctors can tailor treatments and follow-up care to improve outcomes and reduce the risk of long-term mortality. This study highlights the importance of a comprehensive approach to managing CAP, considering both the patient's health conditions and specific biomarkers to develop personalized treatment plans. Further research is needed to validate these findings and explore how to implement them effectively in clinical practice.