The Roles of the Charlson Comorbidity Index and Time to First Antibiotic Dose as Predictors of Outcome in Pneumococcal Community-Acquired Pneumonia

Franzen, Daniel; Lim, Marisa Manuela Gomes Meirinhos; Bratton, Daniel J.; Kuster, Stefan P.; Kohler, Malcolm

doi:10.1007/s00408-016-9922-z

“…These findings indicate a relationship between a patient's comorbid burden and the consequences of community-acquired pneumonia [59]. Results of a study among 108 patients by Franzen et al indicated that the death risk of hospitalized pneumonia patients tended to increase with a higher CCI [58].…”

Section: Comorbiditiesmentioning

confidence: 96%

“…In patients with pneumonia, comorbidities are also associated with poor response to treatment. Moreover, patients older than 80 years with comorbidities also have a higher mortality rate than patients from other age groups [58].…”

Section: Comorbiditiesmentioning

confidence: 99%

Pneumonia: Drug-Related Problems and Hospital Readmissions

Nguyen¹,

Pham²,

Vo³

et al. 2022

Infectious Diseases

View full text Add to dashboard Cite

Pneumonia is one of the most common infectious diseases and the fourth leading cause of death globally. According to US statistics in 2019, pneumonia is the most common cause of sepsis and septic shock. In the US, inpatient pneumonia hospitalizations account for the top 10 highest medical costs, totaling $9.5 billion for 960,000 hospital stays. The emergence of antibiotic resistance in the treatment of infectious diseases, including the treatment of pneumonia, is a globally alarming problem. Antibiotic resistance increases the risk of death and re-hospitalization, prolongs hospital stays, and increases treatment costs, and is one of the greatest threats in modern medicine. Drug-related problems (DRPs) in pneumonia - such as suboptimal antibiotic indications, prolonged treatment duration, and drug interactions - increase the rate of antibiotic resistance and adverse effects, thereby leading to an increased burden in treatment. In a context in which novel and effective antibiotics are scarce, mitigating DRPs in order to reduce antibiotic resistance is currently a prime concern. A variety of interventions proven useful in reducing DRPs are antibiotic stewardship programs, the use of biomarkers, computerized physician order entries and clinical decision support systems, and community-acquired pneumonia scores.

show abstract

“…This interesting result stems from the fact that, although the index has been proven reliable for the long-term prognosis of CAP, there has been little discussion on how it influences short-term outcomes. In their study of 108 patients, Franzen and colleagues [17] reported that pneumonia in-hospital mortality trended upward as CCI rose (HR 1.10; 95% CI 0.99 to 1.23). In another study conducted on 373…”

Section: Discussionmentioning

confidence: 98%

The effect of comorbidities for the prognosis of community-acquired pneumonia: an epidemiologic study using a hospital surveillance in Japan

Nguyen

¹

,

Saito²,

Wagatsuma

³

2019

Preprint

View full text Add to dashboard Cite

Objective Pneumonia is a common but serious illness that continues to present significant morbidity and mortality. Although the effect of severity at admission on outcome has been well reported, the role of comorbidity is still not widely understood. The Charlson Comorbidity Index measures comorbidity with a well-established history of predicting long-term outcome but its utility in pneumonia prognosis is still limited. Here, we use the Charlson Comorbidity Index and hospital surveillance data to investigate associations between comorbidities and in-hospital mortality due to community-acquired pneumonia.Results Among the 535 eligible adult patients (69.0% male, median [IQR] age, 79 [70-84] years), 100 (18.7%) acquired severe to extremely severe pneumonia. The median [IQR] CCI was 1[1-3]. Malignancy (129 of 535, 24.1%), chronic pulmonary diseases (113 of 535, 21.1%) and congestive heart failure (103 of 535, 19.3%) were frequent. Higher Charlson Comorbidity Index scores were associated with higher risk of in-hospital mortality (OR 1.28; 95% CI 1.07-1.53). These results support the inclusion of comorbid burden in predicting community-acquired pneumonia outcome.

show abstract

“…This interesting result stems from the fact that, although the index has been proven reliable for the long-term prognosis of CAP, there has been little discussion on how it influences short-term outcomes. In their study of 108 patients, Franzen and colleagues [15] reported that pneumonia in-hospital mortality trended upward as CCI rose (HR 1.10; 95% CI 0.99 to 1.23). In another study conducted on 373…”

Section: Discussionmentioning

confidence: 98%

The effect of comorbidities for the prognosis of community-acquired pneumonia: an epidemiologic study using a hospital surveillance in Japan

Nguyen

¹

,

Saito²,

Wagatsuma

³

2019

Preprint

0

View full text Add to dashboard Cite

Objective Pneumonia is a common but serious illness that continues to present significant morbidity and mortality. Although the effect of severity at admission on outcome has been well reported, the role of comorbidity is still not widely understood. The Charlson Comorbidity Index measures comorbidity with a well-established history of predicting long-term outcome but its utility in pneumonia prognosis is still limited. Here, we use the Charlson Comorbidity Index and hospital surveillance data to investigate associations between comorbidities and in-hospital mortality due to community-acquired pneumonia.Results Among the 535 eligible adult patients (69.0% male, median [IQR] age, 79 [70-84] years), 100 (18.7%) acquired severe to extremely severe pneumonia. The median [IQR] CCI was 1[1-3]. Malignancy (129 of 535, 24.1%), chronic pulmonary diseases (113 of 535, 21.1%) and congestive heart failure (103 of 535, 19.3%) were frequent. Higher Charlson Comorbidity Index scores were associated with higher risk of in-hospital mortality (OR 1.28; 95% CI 1.07-1.53). These results support the inclusion of comorbid burden in predicting community-acquired pneumonia outcome.

show abstract

The Roles of the Charlson Comorbidity Index and Time to First Antibiotic Dose as Predictors of Outcome in Pneumococcal Community-Acquired Pneumonia

Abstract: In this study including comparatively young patients with rather mild disease severity, we found no strong evidence supporting that CCI or TFAD influenced short-term outcome measures of PCAP. Yet, pneumonia severity appears to be the most important factor for the outcome.

Cited by 5 publications

References 22 publications

Pneumonia: Drug-Related Problems and Hospital Readmissions

Pneumonia: Drug-Related Problems and Hospital Readmissions

The effect of comorbidities for the prognosis of community-acquired pneumonia: an epidemiologic study using a hospital surveillance in Japan

The effect of comorbidities for the prognosis of community-acquired pneumonia: an epidemiologic study using a hospital surveillance in Japan

Contact Info

Product

Resources

About