The online version of this article (doi:10.1186/s12879-017-2302-3) contains supplementary material, which is available to authorized users.
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.
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.
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.
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.
Additional file 1: Figure S1A. Observed EQ-5D indexes for suspected pneumonia cases and non-diseased subjects during the one-year post-discharge period, excluding the CAP episode. Figure S2A. Survivors (%) in the diseased cohort (i.e. suspected pneumonia cases) and the non-diseased cohort during the one-year follow-up. Figure S3A. Mean EQ-5D-3 L-index, EQ-VAS and SF6D-index at different contact moments for the suspected CAP cases and the non-diseased subjects, respectively. Figure S4A. Profile of the population using EQ5D-instrument: Percentage reporting any problems per domain at different contact moments for A) the radiologically confirmed CAP cases and their non-diseased subjects, and B) the radiologically non-confirmed CAP cases and their non-diseased subjects, respectively. Figure S5A. SF-36 mean scale scores at different contact moments for A) the radiologically confirmed CAP cases and their non-diseased subjects, and B) the radiologically non-confirmed CAP cases and their non-diseased subjects, respectively. Figure S6A. Mean EQ-5D-3 L-index, EQ-VAS and SF6D-index at different contact moments for the radiologically confirmed CAP cases and their non-diseased subjects (A), and for the radiologically non-confirmed CAP cases and their non-diseased subjects (B). Table S1A. Exclusion criteria and reasons for nonparticipation in the “diseased” cohort of eligible suspected pneumonia episodes. Table S2A. Living situation, loss-to-follow up and deaths of suspected pneumonia cases and non-diseased subjects during the one-year follow-up. Table S3A. Spearman’s rho for EQ-VAS, EQ5D-index and SF6D-index at the different contact moments for suspected pneumonia cases. Table S4A. Spearman’s rho for EQ-VAS, EQ5D-index and SF6D-index at the different contact moments for non-diseased subjects. Table S5A. Baseline characteristics of radiologically confirmed and non-confirmed CAP cases and their non-diseased subjects. Table S6A. Living situation, loss-to-follow up and mortality of radiologically confirmed and non-confirmed CAP cases and their non-diseased subjects during the one-year follow-up. Table S7A. EQ5D-index, EQ-VAS and SF6D-index for the radiologically confirmed and non-confirmed CAP cases and their non-diseased subjects. Table S8A. Utility differences attributable to radiologically confirmed CAP and radiologically non-confirmed CAP, respectively. (DOCX 602 kb)12879_2017_2302_MOESM1_ESM.docx
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- The impact of community-acquired pneumonia on the health-related quality-of-life in elderly
Marie-Josée J. Mangen
Susanne M. Huijts
Marc J. M. Bonten
G. Ardine de Wit
- BioMed Central
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