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The clinical state of the patient at time of presentation is a strong predictor of the clinical course. Many clinicians use the Pneumonia Severity Score to calculate whether a patient requires admission to hospital, based on the severity of symptoms, underlying disease and age. In the United States mortality from pneumococcal pneumonia is 1 in 20, in cases where the disease progresses to blood poisoning, bacteremia, 2 of 10 die and where the disease affects the brain, meningitis, 3 of 10 die.
Prognosis of pneumonia caused by Chlamydophila pneumoniae is excellent. Hospitalization is uncommon, complications are rare, and most people have no residual deficits. In fact, Chlamydophila pneumoniae is a common cause of walking pneumonia, so named because most people are able to continue to walk and participate in reduced activity during infection.
About 1.2 million people are hospitalized each year for pneumonia, which is the third most frequent reason for hospitalizations (births are first and heart disease is second). Although the majority of pneumonias respond well to treatment, the infection can still be a very serious problem. It kills between 40,000 and 70,000 people each year. Together with influenza, pneumonia is the sixth leading cause of death in the US and is the leading cause of death from infection.
Hospitalized Patients For patients who require hospitalization for pneumonia, the mortality rate is between 10% and 25%. If pneumonia develops in patients already hospitalized for other conditions, the mortality rates are higher. They range from 50% to 70% and are greater in women than in men.
Older Adults Community-acquired pneumonia is responsible for 350,000 to 620,000 hospitalizations in elderly people every year. The elderly have lower survival rates than younger people, and pneumonia and influenza are the fifth leading causes of death in this population. Even when older individuals recover from community-acquired pneumonia, they have higher than normal mortality rates over the next several years. Elderly people at particular risk are those with other medical problems and nursing home patients.
Very Young Children About 20% of deaths in stillborn and very young infants are due to pneumonia. Small children who develop pneumonia and survive are at also at risk for developing lung problems in adulthood.
Pregnant Women Pneumonia poses a special hazard for pregnant women.
Patients With Impaired Immune Systems Pneumonia is particularly serious in people with impaired immune systems, particularly AIDS patients, in whom pneumonia causes about half of all deaths.
Patients With Serious Medical Conditions The disease is also very dangerous in people with diabetes, cirrhosis, sickle cell disease, cancer, and in those who have had their spleens removed.
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