Systematic review and meta-analysis of comorbidities and associated risk factors in Indian patients of community-acquired pneumonia

Ghia, Canna Jagdish; Rambhad, Gautam

doi:10.1177/20503121221095485

Cited by 11 publications

(12 citation statements)

References 34 publications

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“…For instance, we previously revealed that comorbidities were independent risk factors influencing in-hospital mortality in patients over 80 years old with CAP 21 . As well, Ghia et al found comorbid conditions like chronic obstructive pulmonary disease, hypertension were common risk factors for CAP in the Indian population 22 . On this basis, we propose that more attention should be paid to the care of comorbidities in elderly patients with CAP, especially aged over 85.…”

Section: Discussionmentioning

confidence: 89%

Establishment of risk model for elderly CAP at different age stages: a single-center retrospective observational study

Lv,

Pan,

Shi

et al. 2023

Sci Rep

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Community-acquired pneumonia (CAP) is one of the main reasons of mortality and morbidity in elderly population, causing substantial clinical and economic impacts. However, clinically available score systems have been shown to demonstrate poor prediction of mortality for patients aged over 65. Especially, no existing clinical model can predict morbidity and mortality for CAP patients among different age stages. Here, we aimed to understand the impact of age variable on the establishment of assessment model and explored prognostic factors and new biomarkers in predicting mortality. We retrospectively analyzed elderly patients with CAP in Minhang Hospital, Fudan University. We used univariate and multiple logistic regression analyses to study the prognostic factors of mortality in each age-based subgroup. The prediction accuracy of the prognostic factors was determined by the Receiver Operating Characteristic curves and the area under the curves. Combination models were established using several logistic regressions to save the predicted probabilities. Four factors with independently prognostic significance were shared among all the groups, namely Albumin, BUN, NLR and Pulse, using univariate analysis and multiple logistic regression analysis. Then we built a model with these 4 variables (as ABNP model) to predict the in-hospital mortality in all three groups. The AUC value of the ABNP model were 0.888 (95% CI 0.854–0.917, p < 0.000), 0.912 (95% CI 0.880–0.938, p < 0.000) and 0.872 (95% CI 0.833–0.905, p < 0.000) in group 1, 2 and 3, respectively. We established a predictive model for mortality based on an age variable -specific study of elderly patients with CAP, with higher AUC value than PSI, CURB-65 and qSOFA in predicting mortality in different age groups (66–75/ 76–85/ over 85 years).

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Section: Discussionmentioning

confidence: 89%

Establishment of risk model for elderly CAP at different age stages: a single-center retrospective observational study

Lv,

Pan,

Shi

et al. 2023

Sci Rep

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“…Community-acquired pneumonia (CAP), defined as pneumonia acquired outside the hospital, is one of the most common infectious diseases in clinical practice [ 1 , 2 ]. The incidence of pneumonia increases with age, with a 10 times higher hospitalization rate in patients aged 65 years and older (about 2000 per 100,000 per year) than in the younger population [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a survival prediction model in elder patients with community-acquired pneumonia: a MIMIC-population-based study

Chu

2023

BMC Pulm Med

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Background To develop a prediction model predicting in-hospital mortality of elder patients with community-acquired pneumonia (CAP) admitted to the intensive care unit (ICU). Methods In this cohort study, data of 619 patients with CAP aged ≥ 65 years were obtained from the Medical Information Mart for Intensive Care III (MIMIC III) 2001–2012 database. To establish the robustness of predictor variables, the sample dataset was randomly partitioned into a training set group and a testing set group (ratio: 6.5:3.5). The predictive factors were evaluated using multivariable logistic regression, and then a prediction model was constructed. The prediction model was compared with the widely used assessments: Sequential Organ Failure Assessment (SOFA), Pneumonia Severity Index (PSI), systolic blood pressure, oxygenation, age and respiratory rate (SOAR), CURB-65 scores using positive predictive value (PPV), negative predictive value (NPV), accuracy (ACC), area under the curve (AUC) and 95% confidence interval (CI). The decision curve analysis (DCA) was used to assess the net benefit of the prediction model. Subgroup analysis based on the pathogen was developed. Results Among 402 patients in the training set, 90 (24.63%) elderly CAP patients suffered from 30-day in-hospital mortality, with the median follow-up being 8 days. Hemoglobin/platelets ratio, age, respiratory rate, international normalized ratio, ventilation use, vasopressor use, red cell distribution width/blood urea nitrogen ratio, and Glasgow coma scales were identified as the predictive factors that affect the 30-day in-hospital mortality. The AUC values of the prediction model, the SOFA, SOAR, PSI and CURB-65 scores, were 0.751 (95% CI 0.749–0.752), 0.672 (95% CI 0.670–0.674), 0.607 (95% CI 0.605–0.609), 0.538 (95% CI 0.536–0.540), and 0.645 (95% CI 0.643–0.646), respectively. DCA result demonstrated that the prediction model could provide greater clinical net benefits to CAP patients admitted to the ICU. Concerning the pathogen, the prediction model also reported better predictive performance. Conclusion Our prediction model could predict the 30-day hospital mortality in elder patients with CAP and guide clinicians to identify the high-risk population.

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“…Developing countries bear a significant brunt of the disease, impacting healthcare. 1 Many literatures show that CAP has a high incidence and hospitalization rate (11‰ and 4‰, respectively) and is more likely to recurrence. 2 , 3 , 4 , 5 With the medical interventions level gets more and more advanced and the treatment methods are constantly developing, however, the mortality rate of this disease has not decreased significantly.…”

Section: Introductionmentioning

confidence: 99%

“…Community‐acquired pneumonia (CAP) is a global disease. Developing countries bear a significant brunt of the disease, impacting healthcare 1 . Many literatures show that CAP has a high incidence and hospitalization rate (11‰ and 4‰, respectively) and is more likely to recurrence 2–5 .…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and pathogen analysis of bronchoalveolar lavage fluid in elderly patients with community‐acquired pneumonia

Guo

Zhang

Zhu

et al. 2023

Immunity Inflam & Disease

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Objective To analyze the clinical characteristics and bronchoalveolar lavage fluid pathogens in elderly patients with community‐acquired pneumonia (CAP). Methods This was a retrospective observational epidemiological study using that elderly cases diagnosed with community‐acquired pneumonia receiving treatment at the Affiliated Hospital of North China University of Technology, Tangshan Hongci Hospital and Tangshan Fengnan District Hospital of Traditional Chinese Medicine. A total of 92 cases were divided into two groups according to age. There were 44 patients over 75‐year‐old and 48 patients between 65 and 74‐year‐old. Results Compared with the elderly 65 to 74‐year‐old, the elderly over 75‐year‐old with diabetes are more likely to suffer from CAP (35.42% vs. 63.64%, p = 0.007) and are more likely to have mixed infections (6.25% vs. 22.73%, p = 0.023) or larger lesions (45.83% vs. 68.18%, p = 0.031). Their hospital stays will also be extended (39.58% vs. 63.64%, p = 0.020), and the albumin level (37.51 ± 8.92 vs. 30.93 ± 6.58, p = 0.000), the neutrophils level (9.09(6.26–10.63) vs. 7.18(5.35–9.17),p = 0.026) is significantly lower and the d‐dimer (505.42 ± 197.12 vs. 611.82 ± 195.85, p = 0.011), PCT (0.08 ± 0.04 vs. 0.12 ± 0.07, p = 0.001) levels are significantly higher. Conclusion The clinical symptoms and signs of elderly CAP patients are not so typical, and the infection is more serious. Attention should therefore be paid to elderly patients. Hypoalbuminemia and high d‐dimer can predict the prognosis of patients.

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Systematic review and meta-analysis of comorbidities and associated risk factors in Indian patients of community-acquired pneumonia

Cited by 11 publications

References 34 publications

Establishment of risk model for elderly CAP at different age stages: a single-center retrospective observational study

Establishment of risk model for elderly CAP at different age stages: a single-center retrospective observational study

Development and validation of a survival prediction model in elder patients with community-acquired pneumonia: a MIMIC-population-based study

Clinical characteristics and pathogen analysis of bronchoalveolar lavage fluid in elderly patients with community‐acquired pneumonia

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