Characterizing the timing and causes of death in community-acquired pneumonia.

OBJECTIVE

We assessed the timing and causes of death in subjects hospitalized with community-acquired pneumonia (CAP).

METHODS

A cohort of 2918 immunocompetent adults hospitalized with CAP were followed for 90 days between 2017 and 2020. Each immediate and underlying cause of death was independently assessed by two physicians.

RESULTS

Overall, 19% (562/2918) of patients died within 90 days. Pneumonia-related deaths (243/562 [43%]) primarily occurred within the first two weeks of admission, and respiratory failure was the most common cause of death overall (272/562 [48%]). Later deaths were either unrelated to pneumonia (159/562 [28%]) or from unknown causes (160/562 [28%]), if they occurred out of hospital. Of deceased patients, 314/562 (56%) transitioned to palliative care within the last 7 days of life.

CONCLUSIONS

In a contemporary cohort, CAP-related mortality occurred early, whereas later deaths were driven by comorbidities and increased frailty. Understanding the burden of CAP through specific cause-of death assessment is critical to evaluate treatment effects and to improve outcomes for increasingly frail patient populations.