OBJECTIVE To assess survival and identify predictors of survival more than 30-days after discharge in a cohort of consecutive patients diagnosed with pneumococcal pneumonia. METHODS Observational study including all consecutive immunocompetent adult patients surviving more than 30-days after hospitalization. The bacteriological diagnosis was based on the results of urinary antigen testing and/or blood culture. Life expectancy was calculated for each patient considering their sex, age and date of discharge. RESULTS We included 1114 patients that survived more than 30- days after discharge. Of them, 431 (38.6%) died during follow-up (median follow-up of 6.7 years). Age, history of cancer, liver disease, chronic renal disease, chronic obstructive pulmonary disease, cerebrovascular disease, atrial arrhythmia and coronary disease, red cell distribution width (RDW) > 15%, positive blood culture, hematocrit < 30% and living in a nursing home were independent risk factors for reduced long-term survival after hospital discharge. Cumulative 1-, 3- and 5-year survival rates were 93.9%, 85.3% and 76%, respectively. Among non-survivors, 361 (83.8%) died earlier than expected given their life expectancy. CONCLUSIONS Survival after hospital discharge is mainly associated with age and comorbidities. The findings of bacteremia and elevated RDW on admission could help identify patients at high risk of long-term mortality.

中文翻译：

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影响肺炎球菌性肺炎住院后长期生存的因素。

目的评估一组连续诊断为肺炎球菌性肺炎的患者的生存情况，并确定出院后超过30天的生存预测因素。方法观察性研究包括所有住院后均存活超过30天的连续免疫能力强的成年患者。细菌学诊断基于尿液抗原检测和/或血液培养的结果。考虑到每个患者的性别，年龄和出院日期，计算其预期寿命。结果我们纳入了1114例出院后存活超过30天的患者。其中，有431例（38.6％）在随访期间（中位随访时间为6.7年）死亡。年龄，癌症病史，肝脏疾病，慢性肾脏疾病，慢性阻塞性肺疾病，脑血管疾病，心律失常和冠状动脉疾病，红细胞分布宽度（RDW）> 15％，血液培养阳性，血细胞比容<30％和住在疗养院中是导致出院后长期生存减少的独立危险因素。一年，三年和五年的累计生存率分别为93.9％，85.3％和76％。在非幸存者中，有361人（83.8％）死于预期寿命。结论出院后的生存主要与年龄和合并症有关。入院时的菌血症和RDW升高的发现有助于确定长期死亡风险较高的患者。分别。在非幸存者中，有361人（83.8％）死于预期寿命。结论出院后的生存主要与年龄和合并症有关。入院时的菌血症和RDW升高的发现有助于确定长期死亡风险较高的患者。分别。在非幸存者中，有361人（83.8％）死于预期寿命。结论出院后的生存主要与年龄和合并症有关。入院时的菌血症和RDW升高的发现有助于确定长期死亡风险较高的患者。