Abstract
BACKGROUND: Long-term bedridden elderly individuals face a high risk of community-acquired pneumonia (CAP) amid China's aging population, yet the specific mortality impact remains insufficiently studied. OBJECTIVE: To compare the clinical characteristics and in-hospital mortality between long-term bedridden and ambulatory elderly patients with CAP, and to identify risk factors for mortality. METHODS: This retrospective study included 453 patients aged ≥75 years hospitalized with CAP from March 2016 to March 2019, divided into a bedridden group (n = 162) and a non-bedridden group (n = 291). Data on demographics, comorbidities, frailty (modified Frailty Index-5, mFI-5), functional status (Barthel Index), and laboratory parameters (eg, hs-CRP) were collected. Logistic regression analysis was used to identify predictors of in-hospital mortality. RESULTS: The bedridden group had a significantly higher mortality rate (27.16% vs 2.06%, P < 0.001) and elevated hs-CRP levels (40.2 ± 44.0 mg/L vs 19.9 ± 20.3 mg/L). Multivariate analysis identified bedridden status (OR = 11.99, 95% CI: 4.31-33.40), respiratory failure (OR = 6.80, 95% CI: 3.03-15.28), and renal dysfunction (elevated serum creatinine; OR = 1.01, 95% CI: 1.00-1.02) as independent risk factors for mortality. CONCLUSION: Long-term bedridden status is an independent predictor of in-hospital mortality in elderly CAP patients with inflammatory response potentially playing a critical role.