Exploration of Aging-Care Parameters to Predict Mortality of Patients Aged 80-Years and Above with Community-Acquired Pneumonia

TY - JOUR

T1 - Exploration of Aging-Care Parameters to Predict Mortality of Patients Aged 80-Years and Above with Community-Acquired Pneumonia

AU - Lv, Chunxin

AU - Shi, Wen

AU - Pan, Teng

AU - Li, Houshen

AU - Peng, Weixiong

AU - Xu, Jiayi

AU - Deng, Jinhai

PY - 2022/9/20

Y1 - 2022/9/20

N2 - The study explores a clinical model based on aging-care parameters to predict the mortality of hospitalized patients aged 80-year and above with community-acquired pneumonia (CAP). In this study, four hundred and thirty-five CAP patients aged 80-years and above were enrolled in the Central Hospital of Minhang District, Shanghai during 01,01,2018-31,12,2021. The clinical data were collected, including aging-care relevant factors (ALB, FRAIL, Barthel Index and age-adjusted Charlson Comorbidity Index) and other commonly used factors. The prognostic factors were screened by multivariable logistic regression analysis. Receiver operating characteristic (ROC) curves were used to predict the mortality risk. Univariate analysis demonstrated that several factors, including gender, platelet distribution width, NLR, ALB, CRP, pct, pre-albumin, CURB-65, low-density, lipoprotein, Barthel Index, FRAIL, leucocyte count, neutrophil count, lymphocyte count and aCCI, were associated with the prognosis of CAP. Multivariate model analyses further identified that CURB-65 (p < 0.0001, OR = 5.44, 95% CI = 3.021-10.700), FRAIL (p < 0.0001, OR = 5.441, 95% CI = 2.611-12.25) and aCCI (p = 0.003, OR = 1.551, 95% CI = 1.165-2.099) were independent risk factors, whereas ALB (p = 0.005, OR = 0.871, 95% CI = 0.788-0.957) and Barthel Index (p = 0.0007, OR = 0.958, 95% CI = 0.933-0.981) were independent protective factors. ROC curves were plotted to further predict the in-hospital mortality and revealed that combination of three parameters (Barthel Index+ FRAI +CURB-65) showed the best performance. This study showed that CURB-65, frailty and aCCI were independent risk factors influencing prognosis. In addition, ALB and Barthel Index were protective factors for in CAP patients over 80-years old. AUC was calculated and revealed that combination of three parameters (Barthel Index+ FRAI +CURB-65) showed the best performance. [Abstract copyright: © 2022 Lv et al.]

AB - The study explores a clinical model based on aging-care parameters to predict the mortality of hospitalized patients aged 80-year and above with community-acquired pneumonia (CAP). In this study, four hundred and thirty-five CAP patients aged 80-years and above were enrolled in the Central Hospital of Minhang District, Shanghai during 01,01,2018-31,12,2021. The clinical data were collected, including aging-care relevant factors (ALB, FRAIL, Barthel Index and age-adjusted Charlson Comorbidity Index) and other commonly used factors. The prognostic factors were screened by multivariable logistic regression analysis. Receiver operating characteristic (ROC) curves were used to predict the mortality risk. Univariate analysis demonstrated that several factors, including gender, platelet distribution width, NLR, ALB, CRP, pct, pre-albumin, CURB-65, low-density, lipoprotein, Barthel Index, FRAIL, leucocyte count, neutrophil count, lymphocyte count and aCCI, were associated with the prognosis of CAP. Multivariate model analyses further identified that CURB-65 (p < 0.0001, OR = 5.44, 95% CI = 3.021-10.700), FRAIL (p < 0.0001, OR = 5.441, 95% CI = 2.611-12.25) and aCCI (p = 0.003, OR = 1.551, 95% CI = 1.165-2.099) were independent risk factors, whereas ALB (p = 0.005, OR = 0.871, 95% CI = 0.788-0.957) and Barthel Index (p = 0.0007, OR = 0.958, 95% CI = 0.933-0.981) were independent protective factors. ROC curves were plotted to further predict the in-hospital mortality and revealed that combination of three parameters (Barthel Index+ FRAI +CURB-65) showed the best performance. This study showed that CURB-65, frailty and aCCI were independent risk factors influencing prognosis. In addition, ALB and Barthel Index were protective factors for in CAP patients over 80-years old. AUC was calculated and revealed that combination of three parameters (Barthel Index+ FRAI +CURB-65) showed the best performance. [Abstract copyright: © 2022 Lv et al.]

KW - Aging

KW - Severity of Illness Index

KW - Aged, 80 and over

KW - Pneumonia

KW - functional status

KW - Community-Acquired Infections

KW - Prognosis

KW - aging care

KW - frailty

KW - ROC Curve

KW - CURB65

KW - Retrospective Studies

KW - Humans

KW - China

KW - Albumins

U2 - 10.2147/CIA.S382347

DO - 10.2147/CIA.S382347

M3 - Article

C2 - 36164658

SN - 1176-9092

VL - 17

SP - 1379

EP - 1391

JO - Clinical interventions in aging

JF - Clinical interventions in aging

ER -