Mortality and Prognostic Prediction in Very Elderly Patients With Severe Pneumonia.
Autor: Baek, Moon Seong; Park, Sojung; Choi, Jeong-Hee; Kim, Cheol-Hong; Hyun, In Gyu
Publication year: 2020
Journal of intensive care medicine
issn:1525-1489 0885-0666
doi: 10.1177/0885066619826045
Abstract:
INTRODUCTION: Although prognostic prediction scores for pneumonia such as CURB-65 score or pneumonia severity index (PSI) are widely used, there were a few studies in very elderly patients. The aim of the study was to validate prognostic prediction scores for severe pneumonia and investigate risk factors associated with in-hospital mortality of severe pneumonia in very elderly patients. METHODS: During the 6-year study period (from October 2012 to May 2018), 160 patients aged 80 or older admitted to medical intensive unit were analyzed retrospectively. Pneumonia severity was evaluated using CURB-65 score, PSI, Sequential Organ Failure Assessment (SOFA) scores, A-DROP, I-ROAD, UBMo index, SOAR score, and lactate. The outcome was in-hospital mortality. RESULTS: The median age was 85 years (interquartile range: 82-88). Nursing home residents accounted for 71 (44.4%) and in-hospital mortality was 40 (25.0%). Logistic regression showed that chronic lung, mechanical ventilation, hemodialysis, and albumin were associated with in-hospital mortality of pneumonia. Using the receiver operating characteristics curve for predicting mortality, the area under the curve in pneumonia was 0.65 for the SOFA score, 0.61 for the CURB-65 score, 0.52 for the PSI, 0.58 for the A-DROP, 0.52 for the I-ROAD, 0.54 for UBMo index, 0.59 for SOAR score, and 0.65 for lactate. CONCLUSION: The performances of the CURB-65 and PSI are not excellent in very elderly patients with pneumonia. Further studies are needed to improve the performance of prognostic prediction scores in elderly patients.
Language: eng
Rights:
Pmid: 30678533
Tags: Humans; Aged; Aged, 80 and over; Retrospective Studies; elderly; Prognosis; Severity of Illness Index; ROC Curve; Hospital Mortality; Age Factors; mortality; *Community-Acquired Infections; *Pneumonia/mortality; pneumonia; severity index
Link: https://pubmed.ncbi.nlm.nih.gov/30678533/
