Disability, and not diabetes, is a strong predictor of mortality in oldest old patients hospitalized with pneumonia

Corrao, Salvatore; Argano, Christiano; Natoli, G; Nobili, Alessandro; Corazza, Gino Roberto; Mannucci, Pier Mannuccio; Perticone, Francesco; Investigators, Reposi

doi:10.1016/j.ejim.2018.04.012

Cited by 23 publications

(25 citation statements)

References 24 publications

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“…However, both the PSI and the CURB-65, in contrast to our study data on ADL functional status was lacking. The relationship between comorbidities and survival was found in previously study [25] . However, comorbidities was not found to be a signi cant risk factor for in-hospital mortality by logistic analysis in our study, except for lung cancer in our study.…”

Section: Discussionmentioning

confidence: 57%

Activities of Daily Living (ADL) Predicts in-hospital Mortality in Geriatric Patients with Community-acquired Pneumonia (CAP)

Kang

Fang

wang

et al. 2020

Preprint

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Background: Community-acquired pneumonia (CAP) is an important problem with significant mortality. Activity of daily living (ADL) function decline is associated with increased mortality in elderly patients. We aimed to investigate the prognostic value of ADL at admission on the in-hospital mortality in geriatric patients with pneumonia. Methods: Patients over 65 years old admitted to Beijing Chao-yang hospital due to CAP from June 2012 through June 2020 were retrospectively reviewed by electronic medical records. Risk factors for mortality in pneumonia patients described in literature were included in our study. ADL evaluation at admission was performed by Barthel index (BI). Results: 4880 patients were included, 131 patients (2.7%) died during their admission. 69.5% patients in Dead group had a BI scores < 60. Mean BI score in the Dead group and Alive group were 49.89±30.20 and 81.57±22.14, respectively. Dead group had lower BI scores than Alive group (p＜0.001). A low BI was associated with increased in-hospital mortality. Logistic regression analyses demonstrated that ADL function at admission was significantly and independently associated with the in-hospital mortality, either in younger (age 65-74years) or very elderly (age≥75years) patients. Receiver operating characteristic ( ROC ) curve analysis revealed that BI at admission is an predictor related to in-hospital mortality in elderly patients, The area under the receiver operating characteristic (ROC) curves of BI in predicting in-hospital mortality was 0.81 (with 95% confidence interval: 0.78–0.85).Conclusion: ADL decline is associated with increased risk of in-hospital mortality among elderly patients hospitalized with CAP. ADL function at admission can predict in-hospital mortality in geriatric patients with CAP. Barthel Index (BI) can be used as a simple and convenient method for the assessment of the ADL functional status at admission in geriatric patients with CAP to identify patients at high risk and conducive to clinical decision making.

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Section: Discussionmentioning

confidence: 57%

Activities of Daily Living (ADL) Predicts in-hospital Mortality in Geriatric Patients with Community-acquired Pneumonia (CAP)

Kang

Fang

wang

et al. 2020

Preprint

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“…The current analysis highlighted that COPD patients had a worse functional status than patients without COPD; this is of clinical importance, given that hospitalized elderly patients affected by pneumonia with a clinically significant disability were already shown to have higher mortality risk [33]. Lanièce et al found that severe disability was the most important predictor of early re-admission among elderly inpatients [34].…”

Section: Discussionmentioning

confidence: 77%

“…A recent study showed the importance of BI as a strong predictor of 30-days, 3-and 12-month mortality in elderly patients with pneumonia [33]. Simonetti et al found that pneumonia severity and low functional status are the main factors associated with mortality in elderly people with community acquired pneumonia [50].…”

Section: Discussionmentioning

confidence: 99%

Pattern of comorbidities and 1-year mortality in elderly patients with COPD hospitalized in internal medicine wards: data from the RePoSI Registry

Argano¹,

Scichilone²,

Natoli³

et al. 2020

Intern Emerg Med

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Currently, chronic obstructive pulmonary disease (COPD) represents the fourth cause of death worldwide with significant economic burden. Comorbidities increase in number and severity with age and are identified as important determinants that influence the prognosis. In this observational study, we retrospectively analyzed data collected from the RePoSI register. We aimed to investigate comorbidities and outcomes in a cohort of hospitalized elderly patients with the clinical diagnosis of COPD. Socio-demographic, clinical characteristics and laboratory findings were considered. The association between variables and in-hospital, 3-month and 1-year follow-up were analyzed. Among 4696 in-patients, 932 (19.8%) had a diagnosis of COPD. Patients with COPD had more hospitalization, a significant overt cognitive impairment, a clinically significant disability and more depression in comparison with non-COPD subjects. COPD patients took more drugs, both at admission, in-hospital stay, discharge and 3-month and 1-year follow-up. 14 comorbidities were more frequent in COPD patients. Cerebrovascular disease was an independent predictor of in-hospital mortality. At 3-month follow-up, male sex and hepatic cirrhosis were independently associated with mortality. ICS-LABA therapy was predictor of mortality at in-hospital, 3-month and 1-year follow-up. This analysis showed the severity of impact of COPD and its comorbidities in the real life of internal medicine and geriatric wards.

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“…This study reveals a direct relationship between decreased functional capacity measured by the Barthel index and mortality. Functional status in older people has been identi ed as a prognostic mortality factor in respiratory infections 22 . The current study is the rst to prove a direct relationship between the Barthel index and mortality in COVID-19 infected patients.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 mortality risk factors in older people in a long-term care center.

Heras

Garibaldi

Boix

et al. 2020

Preprint

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Objectives: Despite high rates of COVID-19 infection and increased related mortality have been reported among older adults admitted in long-term care facilities, a limited amount of information is available about the natural course of this pandemic and prognostic factors in this population. In the current study, we aimed to investigate the epidemiologic, demographics, clinical, or therapeutic factors that may predict the prognosis in a cohort of COVID-19 infected elderly in a nursing home.Methods: We conducted a retrospective analysis of all COVID-19 confirmed institutionalized elderly in a nursing home transformed into a reference intermediate healthcare facility from March 15 to June 5, 2020. Epidemiological, demographic, and frailty status before infection, and clinical, laboratory, treatment, and outcome data during infection were collected. We used bivariate analysis and multivariate logistic regression to identify risk factors for mortality.Results: The analysis comprised all 100 COVID-19 confirmed cases during the study period. The median age was 85 years; 62% were female. The case fatality rate was 20%. In the bivariate analysis, male gender, fever, respiratory symptoms, severe cognitive decline, a low Barthel index, and lymphocytopenia were significantly associated with mortality. Multivariate logistic regression analysis identified male gender, low Barthel index, no pharmacological treatment, and lymphocytopenia as independent risk factors associated with mortality.Conclusions and Implications: Male gender, low Barthel index, no pharmacological treatment and lymphocytopenia are independent risk factors for COVID-19 mortality in institutionalized elderly patients in long-term care nursing homes. Treatment with hydroxychloroquine and azithromycin was associated with lower mortality in these patients.

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Disability, and not diabetes, is a strong predictor of mortality in oldest old patients hospitalized with pneumonia

Cited by 23 publications

References 24 publications

Activities of Daily Living (ADL) Predicts in-hospital Mortality in Geriatric Patients with Community-acquired Pneumonia (CAP)

Activities of Daily Living (ADL) Predicts in-hospital Mortality in Geriatric Patients with Community-acquired Pneumonia (CAP)

Pattern of comorbidities and 1-year mortality in elderly patients with COPD hospitalized in internal medicine wards: data from the RePoSI Registry

COVID-19 mortality risk factors in older people in a long-term care center.

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