Six underlying health conditions strongly influence mortality based on pneumonia severity in an ageing population of Japan: a prospective cohort study

Hamaguchi, Sugihiro; Suzuki, Motoi; Sasaki, Kenji; Abe, Masao; Wakabayashi, T.; Sando, Eiichiro; Yaegashi, Makito; Morimoto, Shimpei; Asoh, Norichika; Hamashige, Naohisa; Aoshima, Masahiro; Ariyoshi, Koya; Morimoto, Konosuke

doi:10.1186/s12890-018-0648-y

Cited by 15 publications

(10 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Emergency Medicine International conditions may strongly influence mortality based on pneumonia severity in aged populations [15]. A study by Zhang et al demonstrated that PSI performed better than CURB65 for mortality prediction, while its discriminative power decreased with advancing age [16].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Prediction Value of qSOFA, SOFA, and Admission Lactate in Septic Patients with Community-Acquired Pneumonia in Emergency Department

Zhou

Lan

Guo

2020

Emergency Medicine International

View full text Add to dashboard Cite

Background. Community-acquired pneumonia (CAP) is a leading cause of sepsis and common presentation to emergency department (ED) with a high mortality rate. The prognostic prediction value of sequential organ failure assessment (SOFA) and quick SOFA (qSOFA) scores in CAP in ED has not been validated in detail. The aim of this research is to investigate the prognostic prediction value of SOFA, qSOFA, and admission lactate compared with that of other commonly used severity scores (CURB65, CRB65, and PSI) in septic patients with CAP in ED. Methods. Adult septic patients with CAP admitted between Jan. 2017 and Jan. 2019 with increased admission SOFA ≥ 2 from baseline were enrolled. The primary outcome was 28-day mortality. The secondary outcome included intensive care unit (ICU) admission, mechanical ventilation, and vasopressor use. Prognostic prediction performance of the parameters above was compared using receiver operating characteristic (ROC) curves. Kaplan–Meier survival curves were compared using optimal cutoff values of qSOFA and admission lactate. Results. Among the 336 enrolled septic patients with CAP, 89 patients died and 247 patients survived after 28-day follow-up. The CURB65, CRB65, PSI, SOFA, qSOFA, and admission lactate levels were statistically significantly higher in the death group (P<0.001). qSOFA and SOFA were superior and the combination of qSOFA + lactate and SOFA + lactate outperformed other combinations of severity score and admission lactate in predicting both primary and secondary outcomes. Patients with admission qSOFA < 2 or lactate ≤ 2 mmol/L showed significantly prolonged survival than those patients with qSOFA ≥ 2 or lactate > 2 mmol/L (log-rank χ2 = 59.825, P<0.001). The prognostic prediction performance of the combination of qSOFA and admission lactate was comparable to the full version of SOFA (AUROC 0.833 vs. 0.795, Z = 1.378, P=0.168 in predicting 28-day mortality; AUROC 0.868 vs. 0.895, Z = 1.022, P=0.307 in predicting ICU admission; AUROC 0.868 vs. 0.845, Z = 0.921, P=0.357 in predicting mechanical ventilation; AUROC 0.875 vs. 0.821, Z = 2.12, P=0.034 in predicting vasopressor use). Conclusion. qSOFA and SOFA were superior to CURB65, CRB65, and PSI in predicting 28-day mortality, ICU admission, mechanical ventilation, and vasopressor use for septic patients with CAP in ED. Admission qSOFA with lactate is a convenient and useful predictor. Admission qSOFA ≥ 2 or lactate > 2 mmol/L would be very helpful in discriminating high-risk patients with a higher mortality rate.

show abstract

Section: Discussionmentioning

confidence: 99%

Prognostic Prediction Value of qSOFA, SOFA, and Admission Lactate in Septic Patients with Community-Acquired Pneumonia in Emergency Department

Zhou

Lan

Guo

2020

Emergency Medicine International

View full text Add to dashboard Cite

show abstract

“…In addition, PSI underestimate severity of young patients with CAP and was not advised to guide ICU admission, [17,18] and the underlying health conditions may strongly influence mortality based on severity in elderly patients. [19] Study by Zhang et al showed that PSI performed better than CURB65 for mortality prediction, while its discriminative power decreased with advancing age. [20] However, in our study, the predicting performance for 28-day mortality of PSI was similar to qSOFA and CURB65.…”

Section: Discussionmentioning

confidence: 99%

Stratified and prognostic value of admission lactate and severity scores in patients with community-acquired pneumonia in emergency department

2019

View full text Add to dashboard Cite

Background:Community-acquired pneumonia (CAP) is a potentially life-threatening condition. The aim of this study is to investigate the stratified and prognostic value of admission lactate and severity scores (confusion, urea >7 mmol/L, respiratory rate ≥30/min, blood pressure <90 mm Hg systolic and/or ≤60 mm Hg diastolic, and age ≥65 years [CURB65], pneumonia severity index [PSI], sequential organ failure assessment [SOFA], qSOFA) in patients with CAP in emergency department.Methods:Adult patients diagnosed with CAP admitted between January 2017 and January 2019 were enrolled and divided into severe CAP (SCAP) group and nonSCAP (NSCAP) group according to international guidelines, death group, and survival group according to 28-day prognosis. Predicting performance of parameters above was compared using receiver operating characteristic curves and logistic regression model. Cox proportional hazard regression model was used to identify variables independently associated with 28-day mortality.Results:A total of 350 patients with CAP were enrolled. About 196 patients were classified as SCAP and 74 patients died after a 28-day follow-up. The levels of CURB65, PSI, SOFA, qSOFA, and admission lactate were higher in the SCAP group and death group. SOFA showed advantage in predicting SCAP, while qSOFA is superior in predicting 28-day mortality. The combination of SOFA and admission lactate outperformed other combinations in predicting SCAP, and the combination of qSOFA and lactate showed highest superiority over other combinations in predicting 28-day mortality.Conclusion:The SOFA is a valuable predictor for SCAP and qSOFA is superior in predicting 28-day mortality. Combination of qSOFA and admission lactate can improve the predicting performance of single qSOFA.

show abstract

“…6,21 Several studies have reported the utility of serum albumin levels and BMI as prognostic factors for older patients with pneumonia. [23][24][25][26] Nevertheless, despite the ease of evaluating these indicators, they may be influenced by various factors.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of geriatric nutritional risk index for aspiration pneumonia: a retrospective study

Araki¹,

Yamazaki²,

Goto³

et al. 2021

Preprint

View full text Add to dashboard Cite

Background/Objectives: The clinical characteristics and prognostic factors of aspiration pneumonia remain poorly defined. Geriatric nutrition risk index (GNRI) has recently been reported to exhibit a prognostic value for several diseases in older adults. Thus, we aimed to investigate the clinical characteristics and prognostic significance of GNRI for aspiration pneumonia in a sample of older adult patients. Design: Retrospective observational cohort study. Setting: Single-institute acute-phase community hospital. Participants: Patients with aspiration pneumonia diagnosed at our institute between April 2014 and March 2016. Measurements: Data on patient characteristics, microbiological findings, and clinical course were extracted from electronic medical records. The primary outcome was in-hospital mortality. Receiver operating characteristic curve (ROC) analysis was conducted to compare the predictive value of each parameter. Logistic regression analysis was performed to identify independent prognostic factors. Results: Overall, 587 patients with aspiration pneumonia aged ≥ 65 years were enrolled. The mean age was 86 years. Among the patients, 97 patients (16.5%) died. ROC analysis for in-hospital mortality revealed that GNRI had a greater area under the curve value than albumin, body mass index, and A-DROP score, with a significant difference between GNRI and albumin (p=0.0058). Male gender sex (odds ratio [OR]: 1.88, p = 0.028,), chronic heart failure (OR: 2.14, p = 0.023), history of malignancy (OR: 2.66, p = 0.0025), lower GNRI (OR: 0.94, p < 0.001), and initial antibiotic change (OR: 4.22, p < 0.001) were identified as independent adverse prognostic factors in the multivariate analysis. Conclusion: Our findings indicate that GNRI is a potential prognostic marker for older adults with aspiration pneumonia and may act as a proxy for disease severity. Our results support the use of GNRI in the clinical management of aspiration pneumonia.

show abstract

Six underlying health conditions strongly influence mortality based on pneumonia severity in an ageing population of Japan: a prospective cohort study

Cited by 15 publications

References 30 publications

Prognostic Prediction Value of qSOFA, SOFA, and Admission Lactate in Septic Patients with Community-Acquired Pneumonia in Emergency Department

Prognostic Prediction Value of qSOFA, SOFA, and Admission Lactate in Septic Patients with Community-Acquired Pneumonia in Emergency Department

Stratified and prognostic value of admission lactate and severity scores in patients with community-acquired pneumonia in emergency department

Prognostic value of geriatric nutritional risk index for aspiration pneumonia: a retrospective study

Contact Info

Product

Resources

About