Factors influencing prognosis of pneumonia in elderly patients

Wawruch, Martin; Krčmery, S.; Bozekova, L; Wsólová, Ladislava; Laššán, Štefan; Slobodova, Zuzana; Kriska, M

doi:10.1007/bf03327403

Cited by 14 publications

(9 citation statements)

References 15 publications

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“…Immobilization is a significant mortality-predicting characteristic in the elderly hospitalized with pneumonia [35]. Early mobilization, defined as out of bed at least 20 minutes daily from day one of hospitalization, reduced LOS in hospitalized patients with community-acquired pneumonia [9].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of osteopathic manipulation as an adjunctive treatment for hospitalized patients with pneumonia: a randomized controlled trial

Noll¹,

Degenhardt

Morley

et al. 2010

Osteopathic Medicine and Primary Care

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BackgroundThe Multicenter Osteopathic Pneumonia Study in the Elderly (MOPSE) is a registered, double-blinded, randomized, controlled trial designed to assess the efficacy of osteopathic manipulative treatment (OMT) as an adjunctive treatment in elderly patients with pneumonia.Methods406 subjects aged ≥ 50 years hospitalized with pneumonia at 7 community hospitals were randomized using concealed allocation to conventional care only (CCO), light-touch treatment (LT), or OMT groups. All subjects received conventional treatment for pneumonia. OMT and LT groups received group-specific protocols for 15 minutes, twice daily until discharge, cessation of antibiotics, respiratory failure, death, or withdrawal from the study. The primary outcomes were hospital length of stay (LOS), time to clinical stability, and a symptomatic and functional recovery score.ResultsIntention-to-treat (ITT) analysis (n = 387) found no significant differences between groups. Per-protocol (PP) analysis (n = 318) found a significant difference between groups (P = 0.01) in LOS. Multiple comparisons indicated a reduction in median LOS (95% confidence interval) for the OMT group (3.5 [3.2-4.0] days) versus the CCO group (4.5 [3.9-4.9] days), but not versus the LT group (3.9 [3.5-4.8] days). Secondary outcomes of duration of intravenous antibiotics and treatment endpoint were also significantly different between groups (P = 0.05 and 0.006, respectively). Duration of intravenous antibiotics and death or respiratory failure were lower for the OMT group versus the CCO group, but not versus the LT group.ConclusionsITT analysis found no differences between groups. PP analysis found significant reductions in LOS, duration of intravenous antibiotics, and respiratory failure or death when OMT was compared to CCO. Given the prevalence of pneumonia, adjunctive OMT merits further study.

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Section: Discussionmentioning

confidence: 99%

Efficacy of osteopathic manipulation as an adjunctive treatment for hospitalized patients with pneumonia: a randomized controlled trial

Noll¹,

Degenhardt

Morley

et al. 2010

Osteopathic Medicine and Primary Care

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show abstract

“…Ambulation stimulates ventilation, increases perfusion, promotes secretion clearance and oxygenation [15]. Reduced mobility has been shown to be not only one of the major risk factors for pneumonia [16], but it also has an adverse effect on prognosis [17].…”

Section: Pulmonary Complications and Physical Activitymentioning

confidence: 99%

Analysis of bedside entertainment services’ effect on post cardiac surgery physical activity: a prospective, randomised clinical trial

Papaspyros

Uppal

Khan

et al. 2008

European Journal of Cardio-Thoracic Surgery

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“…The most common cause of death after acute spine fractures was pneumonia, followed by ischemic heart disease. Patients with acute spine fractures are likely to have greater pain, leading to immobility and thereby predisposing them to pneumonia [26,27]. They are also susceptible to other pulmonary problems and are at an increased risk of subsequent nonvertebral problems [28].…”

Section: Discussionmentioning

confidence: 99%

Factors Impacting Mortality in Geriatric Patients with Acute Spine Fractures: A 12-Year Study of 613 Patients in Singapore

et al. 2019

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Study Design Retrospective database analysis. Purpose To identify risk factors that predict mortality following acute spine fractures in geriatric patients of Singapore. Overview of Literature Acute geriatric spinal fractures contribute significantly to local healthcare costs and hospital admissions. However, geriatric mortality following acute spine fractures is scarcely assessed in the Asian population. Methods Electronic records of 3,010 patients who presented to our hospital’s emergency department and who were subsequently admitted during 2004–2015 with alleged history of traumatic spine fractures were retrospectively reviewed, and 613 patients (mean age, 85.7±4.5 years; range, 80–101 years; men, 108; women, 505) were shortlisted. Mortality rates were reviewed up to 1 year after admission and multivariate analyses were performed to identify independent risk factors correlating with mortality. Results Women were more susceptible to spine fractures (82.4%), with falls (77.8%) being the most common mechanism of injury. Mortality rates were 6.0%, 8.2%, and 10.4% at 3, 6, and 12 months, respectively. The most common causes of death at all 3 time points were pneumonia and ischemic heart disease. Based on the multivariate analysis at 1-year follow-up, elderly women had a lower mortality rate compared to men ( p <0.001); mortality rates increased by 6.3% ( p =0.024) for every 1-year increase in the patient’s age; and patients with an American Spinal Injury Association (ASIA) score of A–C had a much higher mortality rate compared to those with an ASIA score of D–E ( p <0.001). Conclusions An older age at presentation, male sex, and an ASIA score of A–C were identified as independent factors predicting increased mortality among geriatric patients who sustained acute spine fractures. The study findings highlight at-risk groups for acute spine fractures, thereby providing an opportunity to develop strategies to increase the life expectancy of these patients.

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Factors influencing prognosis of pneumonia in elderly patients

Abstract: Patients with immobilization, congestive heart failure, immunosuppressive therapy, or psychiatric diseases run a high risk of death and require intensive medical care.

Cited by 14 publications

References 15 publications

Efficacy of osteopathic manipulation as an adjunctive treatment for hospitalized patients with pneumonia: a randomized controlled trial

Efficacy of osteopathic manipulation as an adjunctive treatment for hospitalized patients with pneumonia: a randomized controlled trial

Analysis of bedside entertainment services’ effect on post cardiac surgery physical activity: a prospective, randomised clinical trial

Factors Impacting Mortality in Geriatric Patients with Acute Spine Fractures: A 12-Year Study of 613 Patients in Singapore

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