Disability, and not diabetes, is a strong predictor of mortality in oldest old patients hospitalized with pneumonia

REPOSI investigators

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Pneumonia causes more deaths than any other infectious disease, especially in older patients with multiple chronic diseases. Recent studies identified a low functional status as prognostic factor for mortality in elderly patients with pneumonia while contrasting data are available about the role of diabetes. The aim of this study was to evaluate the in-hospital, 3-month and 1-year mortality in elderly subjects affected by pneumonia enrolled in the RePoSi register.

METHODS: We retrospectively analyzed the data collected on hospitalized elderly patients in the frame of the REPOSI project. We analyzed the socio-demographic, laboratory and clinical characteristics of subjects with pneumonia. Multivariate logistic analysis was used to explore the relationship between variables and mortality.

RESULTS: Among 4714 patients 284 had pneumonia. 52.8% were males and the mean age was 80 years old. 19.8% of these patients had a Barthel Index ≤40 (p ˂ 0.0001), as well as 43.2% had a short blessed test ≥10 (p ˂ 0.0117). In these subjects a significant CIRS for the evaluation of severity and comorbidity indexes (p ˂ 0.0001) were present. Although a higher fasting glucose level was identified in people with pneumonia, in the multivariate logistic analysis diabetes was not independently associated with in-hospital, 3-month and 1-year mortality, whereas patients with lower Barthel Index had a higher mortality risk (odds ratio being 9.45, 6.84, 19.55 in hospital, at 3 and 12 months).

CONCLUSION: Elderly hospitalized patients affected by pneumonia with a clinically significant disability had a higher mortality risk while diabetes does not represent an important determinant of short and long-term outcome.

Original languageEnglish
Pages (from-to)53-59
Number of pages7
JournalEuropean Journal of Internal Medicine
Volume54
DOIs
Publication statusPublished - Aug 2018

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Pneumonia
Mortality
Multivariate Analysis
Odds Ratio
Communicable Diseases
Comorbidity
Cause of Death
Fasting
Demography
Glucose

Keywords

  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Diabetes Mellitus/epidemiology
  • Disabled Persons/statistics & numerical data
  • Female
  • Geriatric Assessment/statistics & numerical data
  • Hospitalization/statistics & numerical data
  • Humans
  • Italy/epidemiology
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Pneumonia/etiology
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index

Cite this

Disability, and not diabetes, is a strong predictor of mortality in oldest old patients hospitalized with pneumonia. / REPOSI investigators.

In: European Journal of Internal Medicine, Vol. 54, 08.2018, p. 53-59.

Research output: Contribution to journalArticle

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title = "Disability, and not diabetes, is a strong predictor of mortality in oldest old patients hospitalized with pneumonia",
abstract = "BACKGROUND: Pneumonia causes more deaths than any other infectious disease, especially in older patients with multiple chronic diseases. Recent studies identified a low functional status as prognostic factor for mortality in elderly patients with pneumonia while contrasting data are available about the role of diabetes. The aim of this study was to evaluate the in-hospital, 3-month and 1-year mortality in elderly subjects affected by pneumonia enrolled in the RePoSi register.METHODS: We retrospectively analyzed the data collected on hospitalized elderly patients in the frame of the REPOSI project. We analyzed the socio-demographic, laboratory and clinical characteristics of subjects with pneumonia. Multivariate logistic analysis was used to explore the relationship between variables and mortality.RESULTS: Among 4714 patients 284 had pneumonia. 52.8{\%} were males and the mean age was 80 years old. 19.8{\%} of these patients had a Barthel Index ≤40 (p ˂ 0.0001), as well as 43.2{\%} had a short blessed test ≥10 (p ˂ 0.0117). In these subjects a significant CIRS for the evaluation of severity and comorbidity indexes (p ˂ 0.0001) were present. Although a higher fasting glucose level was identified in people with pneumonia, in the multivariate logistic analysis diabetes was not independently associated with in-hospital, 3-month and 1-year mortality, whereas patients with lower Barthel Index had a higher mortality risk (odds ratio being 9.45, 6.84, 19.55 in hospital, at 3 and 12 months).CONCLUSION: Elderly hospitalized patients affected by pneumonia with a clinically significant disability had a higher mortality risk while diabetes does not represent an important determinant of short and long-term outcome.",
keywords = "Aged, Aged, 80 and over, Comorbidity, Diabetes Mellitus/epidemiology, Disabled Persons/statistics & numerical data, Female, Geriatric Assessment/statistics & numerical data, Hospitalization/statistics & numerical data, Humans, Italy/epidemiology, Logistic Models, Male, Multivariate Analysis, Pneumonia/etiology, Retrospective Studies, Risk Factors, Severity of Illness Index",
author = "{REPOSI investigators} and S Corrao and C Argano and G Natoli and A Nobili and Corazza, {G R} and Mannucci, {P M} and F Perticone",
note = "Copyright {\circledC} 2018. Published by Elsevier B.V.",
year = "2018",
month = "8",
doi = "10.1016/j.ejim.2018.04.012",
language = "English",
volume = "54",
pages = "53--59",
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TY - JOUR

T1 - Disability, and not diabetes, is a strong predictor of mortality in oldest old patients hospitalized with pneumonia

AU - REPOSI investigators

AU - Corrao, S

AU - Argano, C

AU - Natoli, G

AU - Nobili, A

AU - Corazza, G R

AU - Mannucci, P M

AU - Perticone, F

N1 - Copyright © 2018. Published by Elsevier B.V.

PY - 2018/8

Y1 - 2018/8

N2 - BACKGROUND: Pneumonia causes more deaths than any other infectious disease, especially in older patients with multiple chronic diseases. Recent studies identified a low functional status as prognostic factor for mortality in elderly patients with pneumonia while contrasting data are available about the role of diabetes. The aim of this study was to evaluate the in-hospital, 3-month and 1-year mortality in elderly subjects affected by pneumonia enrolled in the RePoSi register.METHODS: We retrospectively analyzed the data collected on hospitalized elderly patients in the frame of the REPOSI project. We analyzed the socio-demographic, laboratory and clinical characteristics of subjects with pneumonia. Multivariate logistic analysis was used to explore the relationship between variables and mortality.RESULTS: Among 4714 patients 284 had pneumonia. 52.8% were males and the mean age was 80 years old. 19.8% of these patients had a Barthel Index ≤40 (p ˂ 0.0001), as well as 43.2% had a short blessed test ≥10 (p ˂ 0.0117). In these subjects a significant CIRS for the evaluation of severity and comorbidity indexes (p ˂ 0.0001) were present. Although a higher fasting glucose level was identified in people with pneumonia, in the multivariate logistic analysis diabetes was not independently associated with in-hospital, 3-month and 1-year mortality, whereas patients with lower Barthel Index had a higher mortality risk (odds ratio being 9.45, 6.84, 19.55 in hospital, at 3 and 12 months).CONCLUSION: Elderly hospitalized patients affected by pneumonia with a clinically significant disability had a higher mortality risk while diabetes does not represent an important determinant of short and long-term outcome.

AB - BACKGROUND: Pneumonia causes more deaths than any other infectious disease, especially in older patients with multiple chronic diseases. Recent studies identified a low functional status as prognostic factor for mortality in elderly patients with pneumonia while contrasting data are available about the role of diabetes. The aim of this study was to evaluate the in-hospital, 3-month and 1-year mortality in elderly subjects affected by pneumonia enrolled in the RePoSi register.METHODS: We retrospectively analyzed the data collected on hospitalized elderly patients in the frame of the REPOSI project. We analyzed the socio-demographic, laboratory and clinical characteristics of subjects with pneumonia. Multivariate logistic analysis was used to explore the relationship between variables and mortality.RESULTS: Among 4714 patients 284 had pneumonia. 52.8% were males and the mean age was 80 years old. 19.8% of these patients had a Barthel Index ≤40 (p ˂ 0.0001), as well as 43.2% had a short blessed test ≥10 (p ˂ 0.0117). In these subjects a significant CIRS for the evaluation of severity and comorbidity indexes (p ˂ 0.0001) were present. Although a higher fasting glucose level was identified in people with pneumonia, in the multivariate logistic analysis diabetes was not independently associated with in-hospital, 3-month and 1-year mortality, whereas patients with lower Barthel Index had a higher mortality risk (odds ratio being 9.45, 6.84, 19.55 in hospital, at 3 and 12 months).CONCLUSION: Elderly hospitalized patients affected by pneumonia with a clinically significant disability had a higher mortality risk while diabetes does not represent an important determinant of short and long-term outcome.

KW - Aged

KW - Aged, 80 and over

KW - Comorbidity

KW - Diabetes Mellitus/epidemiology

KW - Disabled Persons/statistics & numerical data

KW - Female

KW - Geriatric Assessment/statistics & numerical data

KW - Hospitalization/statistics & numerical data

KW - Humans

KW - Italy/epidemiology

KW - Logistic Models

KW - Male

KW - Multivariate Analysis

KW - Pneumonia/etiology

KW - Retrospective Studies

KW - Risk Factors

KW - Severity of Illness Index

U2 - 10.1016/j.ejim.2018.04.012

DO - 10.1016/j.ejim.2018.04.012

M3 - Article

VL - 54

SP - 53

EP - 59

JO - European Journal of Internal Medicine

JF - European Journal of Internal Medicine

SN - 0953-6205

ER -