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Development of a score model to predict long-term prognosis after community-onset pneumonia in older patients.
- Source :
-
Respirology (Carlton, Vic.) [Respirology] 2024 Aug; Vol. 29 (8), pp. 722-730. Date of Electronic Publication: 2024 May 20. - Publication Year :
- 2024
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Abstract
- Background and Objective: The identification of factors associated with long-term prognosis after community-onset pneumonia in elderly patients should be considered when initiating advance care planning (ACP). We aimed to identify these factors and develop a prediction score model.<br />Methods: Patients aged 65 years and older, who were hospitalized for pneumonia at nine collaborating institutions, were included. The prognosis of patients 180 days after the completion of antimicrobial treatment for pneumonia was prospectively collected.<br />Results: The total number of analysable cases was 399, excluding 7 outliers and 42 cases with missing data or unknown prognosis. These cases were randomly divided in an 8:2 ratio for score development and testing. The median age was 82 years, and there were 68 (17%) deaths. A multivariate analysis showed that significant factors were performance status (PS) ≥2 (Odds ratio [OR], 11.78), hypoalbuminemia ≤2.5 g/dL (OR, 5.28) and dementia (OR, 3.15), while age and detection of antimicrobial-resistant bacteria were not associated with prognosis. A scoring model was then developed with PS ≥2, Alb ≤2.5, and dementia providing scores of 2, 1 and 1 each, respectively, for a total of 4. The area under the curve was 0.8504, and the sensitivity and specificity were 94.6% and 61.7% at the cutoff of 2, respectively. In the test cases, the sensitivity and specificity were 91.7% and 63.1%, respectively, at a cutoff value of 2.<br />Conclusion: Patients meeting this score should be considered near the end of life, and the initiation of ACP practices should be considered.<br /> (© 2024 Asian Pacific Society of Respirology.)
- Subjects :
- Humans
Female
Male
Prognosis
Aged
Aged, 80 and over
Prospective Studies
Risk Factors
Anti-Bacterial Agents therapeutic use
Predictive Value of Tests
Dementia diagnosis
Dementia epidemiology
Community-Acquired Infections microbiology
Community-Acquired Infections diagnosis
Community-Acquired Infections drug therapy
Pneumonia diagnosis
Pneumonia microbiology
Pneumonia drug therapy
Pneumonia mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1440-1843
- Volume :
- 29
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Respirology (Carlton, Vic.)
- Publication Type :
- Academic Journal
- Accession number :
- 38769707
- Full Text :
- https://doi.org/10.1111/resp.14752