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Development of a score model to predict long-term prognosis after community-onset pneumonia in older patients.
Takazono, Takahiro; Namie, Hotaka; Nagayoshi, Yohsuke; Imamura, Yoshifumi; Ito, Yuya; Sumiyoshi, Makoto; Ashizawa, Nobuyuki; Yoshida, Masataka; Takeda, Kazuaki; Iwanaga, Naoki; Ide, Shotaro; Harada, Yosuke; Hosogaya, Naoki; Takemoto, Shinnosuke; Fukuda, Yuichi; Yamamoto, Kazuko; Miyazaki, Taiga; Sakamoto, Noriho; Obase, Yasushi; Sawai, Toyomitsu; Higashiyama, Yasuhito; Hashiguchi, Kohji; Funakoshi, Satoshi; Suyama, Naofumi; Tanaka, Hikaru; Yanagihara, Katsunori; Izumikawa, Koichi; Mukae, Hiroshi.
Afiliación
  • Takazono T; Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
  • Namie H; Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
  • Nagayoshi Y; Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
  • Imamura Y; Department of Respiratory Medicine, Japanese Red Cross Nagasaki Genbaku Isahaya Hospital, Isahaya, Japan.
  • Ito Y; Medical Education Development Center, Nagasaki University Hospital, Nagasaki, Japan.
  • Sumiyoshi M; Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
  • Ashizawa N; Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, University of Miyazaki, Miyazaki, Japan.
  • Yoshida M; Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
  • Takeda K; Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
  • Iwanaga N; Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
  • Ide S; Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
  • Harada Y; Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
  • Hosogaya N; Department of Internal Medicine, Saiseikai Nagasaki Hospital, Nagasaki, Japan.
  • Takemoto S; Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan.
  • Fukuda Y; Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
  • Yamamoto K; Department of Respiratory Medicine, Sasebo City General Hospital, Sasebo, Japan.
  • Miyazaki T; First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine Okinawa, Okinawa, Japan.
  • Sakamoto N; Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, University of Miyazaki, Miyazaki, Japan.
  • Obase Y; Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
  • Sawai T; Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
  • Higashiyama Y; Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
  • Hashiguchi K; Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
  • Funakoshi S; Department of Respiratory Medicine, Nagasaki Harbor Medical Center, Nagasaki, Japan.
  • Suyama N; Department of Internal Medicine, Hokusho Central Hospital, Sasebo, Japan.
  • Tanaka H; Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan.
  • Yanagihara K; Nagasaki Renal Center, Nagasaki, Japan.
  • Izumikawa K; Department of Internal Medicine, Izumikawa Hospital, Minamishimabara, Japan.
  • Mukae H; Department of Internal Medicine, Senju Hospital, Sasebo, Japan.
Respirology ; 29(8): 722-730, 2024 08.
Article en En | MEDLINE | ID: mdl-38769707
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.

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.

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 82 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.

CONCLUSION:

Patients meeting this score should be considered near the end of life, and the initiation of ACP practices should be considered.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía / Infecciones Comunitarias Adquiridas Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Respirology Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Australia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía / Infecciones Comunitarias Adquiridas Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Respirology Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Australia