Department of Medicine and Therapeutics, Prince of Wales Hospital, the Chinese University of Hong Kong, China.
Age Ageing. 2011 Nov;40(6):736-41. doi: 10.1093/ageing/afr087. Epub 2011 Jul 18.
there were a few studies on the case mortality of pneumonia in older people, of which results were conflicting.
this study aimed to identify risk factors associated with in-hospital mortality in older patients admitted for community-acquired pneumonia (CAP).
a prospective cohort study.
hospital sample.
during the 1-year study period (from October 2009 to September 2010), 488 older patients aged 65 or above were recruited.
demographic characteristics, medical illnesses (Charlson's comorbidity index (CCI)), premorbid functional status (Katz's index) and baseline blood tests were recorded. The outcome was in-hospital mortality.
in this cohort of patients, the mean age was 81.0 years (±7.9) and 282 (57.8%) were male. Nursing home residents accounted for 23.8% (116/488) of study subjects. The median CCI was 2 (inter-quartile range (IQR): 1-3); 60 (12.3%) patients succumbed during hospital stay. Logistic regression showed that comorbidities, mid-arm circumference, serum albumin level and severity of pneumonia (Confusion, blood Urea nitrogen, Respiratory rate and low Blood pressure (CURB) score) were independent predictors of in-hospital mortality of pneumonia.
in keeping with previous studies, CURB score and comorbidities were the most significant independent predictors of mortality of CAP in older patients. Our study concluded that nutritional status was also an important factor affecting their survival. This study failed to demonstrate functional status as a predictor of mortality due to limitation of Katz's index.
有一些关于老年人肺炎病死率的研究，但结果相互矛盾。
本研究旨在确定与社区获得性肺炎（CAP）老年住院患者院内病死率相关的危险因素。
前瞻性队列研究。
医院样本。
在为期 1 年的研究期间（2009 年 10 月至 2010 年 9 月），共招募了 488 名 65 岁及以上的老年患者。
记录人口统计学特征、合并症（Charlson 合并症指数（CCI））、患病前功能状态（Katz 指数）和基线血液检查结果。主要结局是院内病死率。
在该患者队列中，平均年龄为 81.0 岁（±7.9），男性 282 例（57.8%）。23.8%（116/488）的研究对象为疗养院居民。CCI 中位数为 2（四分位距（IQR）：1-3）；60 例（12.3%）患者在住院期间死亡。Logistic 回归显示，合并症、上臂中部周长、血清白蛋白水平和肺炎严重程度（意识障碍、血尿素氮、呼吸频率和低血压（CURB）评分）是肺炎患者院内病死率的独立预测因素。
与以往研究一致，CURB 评分和合并症是影响老年 CAP 患者病死率的最重要的独立预测因素。本研究得出结论，营养状况也是影响其生存的重要因素。由于 Katz 指数的局限性，本研究未能证明功能状态是病死率的预测因素。
