Pneumonia in Long-term Care

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Abstract
PNEUMONIA IS a leading cause of mortality,1,2 morbidity,3-6 and transfer to acute-care facilities7-9 among elderly patients residing in long-term care facilities. The incidence of pneumonia among residents of long-term care facilities ranges from 0.27 to 2.50 per 1000 patient-days,10 with a median reported incidence of 1 per 1000 patient-days. Several clinical series11-17 report short-term mortality from pneumonia ranging from 12% to 44%. The most important determinant of short- and long-term mortality is the patient's functional status.11,13,14 Neither age nor underlying illness appears to have a significant impact after adjusting for level of dependency. Poor functional status is known to be a predictor of mortality in the general long-term care population.18,19 Thus, it is not clear whether an episode of pneumonia is an event that substantially shortens survival or is merely a marker of impending death due to profound debility.

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