Development of a score model to predict long‐term prognosis after community‐onset pneumonia in older patients
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 a...
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| Veröffentlicht in: | Respirology (Carlton, Vic.) Vic.), 2024-08, Vol.29 (8), p.722-730 |
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| creator | 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 |
| description | 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 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.
Conclusion
Patients meeting this score should be considered near the end of life, and the initiation of ACP practices should be considered.
We aimed to identify factors influencing the long‐term prognosis of elderly patients with pneumonia and to develop a prediction score model for the effective initiation of advance care planning. Performance status (PS) ≥2, hypoalbuminemia ≤2.5 g/dL and dementia were significant factors. The scoring model demonstrated 94.6% sensitivity and 61.7% specificity. |
| doi_str_mv | 10.1111/resp.14752 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3057694891</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3057694891</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3162-125eccb54bd9e6e0f6ed5c01b6189bce62cb3a186575dd4845f9b79ff43718a03</originalsourceid><addsrcrecordid>eNp90ctOHiEUB3DS1NRLu-kDGJJuGpOxMMAAS-M9MdH0sp4wzBmDGWCEGc236yP4jD6J6KcuuigbyMkvf07OQegrJfu0nB8J8rRPuRT1B7RFOScVVZx9LG9Ws0pKrTfRds43hBAmiPiENpmSjZZEbqHbI7iDMU4ewozjgA3ONibAPvYw4jniKUHv7IzHGK4f_z7MkHypxesQs8vYDKWAbfR-CW5eFRBDhhlPARYfgzPYBRzHvqDJzK58kj-jjcGMGb683jvoz8nx78Oz6uLy9Pzw4KKyjDZ1RWsB1naCd72GBsjQQC8soV1Dle4sNLXtmKGqEVL0PVdcDLqTehg4k1QZwnbQ93Vu6fZ2gTy33mUL42gCxCW3jIgyBK40LfTbP_QmLimU7opSVBOulShqb61sijknGNopOW_SqqWkfV5E-7yI9mURBe--Ri6dh_6dvk2-ALoG926E1X-i2p_Hv67WoU_y35b6</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3081904985</pqid></control><display><type>article</type><title>Development of a score model to predict long‐term prognosis after community‐onset pneumonia in older patients</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>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</creator><creatorcontrib>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</creatorcontrib><description>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 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.
Conclusion
Patients meeting this score should be considered near the end of life, and the initiation of ACP practices should be considered.
We aimed to identify factors influencing the long‐term prognosis of elderly patients with pneumonia and to develop a prediction score model for the effective initiation of advance care planning. Performance status (PS) ≥2, hypoalbuminemia ≤2.5 g/dL and dementia were significant factors. The scoring model demonstrated 94.6% sensitivity and 61.7% specificity.</description><identifier>ISSN: 1323-7799</identifier><identifier>ISSN: 1440-1843</identifier><identifier>EISSN: 1440-1843</identifier><identifier>DOI: 10.1111/resp.14752</identifier><identifier>PMID: 38769707</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>advance care planning ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents - therapeutic use ; antibiotic resistance ; Community-Acquired Infections - diagnosis ; Community-Acquired Infections - drug therapy ; Community-Acquired Infections - microbiology ; community‐acquired pneumonia ; Dementia ; Dementia - diagnosis ; Dementia - epidemiology ; Dementia disorders ; Female ; healthcare‐associated pneumonia ; Humans ; long‐term prognosis ; Male ; Multivariate analysis ; Pneumonia ; Pneumonia - diagnosis ; Pneumonia - drug therapy ; Pneumonia - microbiology ; Pneumonia - mortality ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Risk Factors ; Sensitivity analysis</subject><ispartof>Respirology (Carlton, Vic.), 2024-08, Vol.29 (8), p.722-730</ispartof><rights>2024 Asian Pacific Society of Respirology.</rights><rights>2024 Asian Pacific Society of Respirology</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3162-125eccb54bd9e6e0f6ed5c01b6189bce62cb3a186575dd4845f9b79ff43718a03</cites><orcidid>0000-0002-7577-476X ; 0000-0001-8838-7403 ; 0000-0002-0696-5386 ; 0000-0001-7872-8147 ; 0000-0003-1295-4357 ; 0000-0002-1357-1676</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fresp.14752$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fresp.14752$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38769707$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Takazono, Takahiro</creatorcontrib><creatorcontrib>Namie, Hotaka</creatorcontrib><creatorcontrib>Nagayoshi, Yohsuke</creatorcontrib><creatorcontrib>Imamura, Yoshifumi</creatorcontrib><creatorcontrib>Ito, Yuya</creatorcontrib><creatorcontrib>Sumiyoshi, Makoto</creatorcontrib><creatorcontrib>Ashizawa, Nobuyuki</creatorcontrib><creatorcontrib>Yoshida, Masataka</creatorcontrib><creatorcontrib>Takeda, Kazuaki</creatorcontrib><creatorcontrib>Iwanaga, Naoki</creatorcontrib><creatorcontrib>Ide, Shotaro</creatorcontrib><creatorcontrib>Harada, Yosuke</creatorcontrib><creatorcontrib>Hosogaya, Naoki</creatorcontrib><creatorcontrib>Takemoto, Shinnosuke</creatorcontrib><creatorcontrib>Fukuda, Yuichi</creatorcontrib><creatorcontrib>Yamamoto, Kazuko</creatorcontrib><creatorcontrib>Miyazaki, Taiga</creatorcontrib><creatorcontrib>Sakamoto, Noriho</creatorcontrib><creatorcontrib>Obase, Yasushi</creatorcontrib><creatorcontrib>Sawai, Toyomitsu</creatorcontrib><creatorcontrib>Higashiyama, Yasuhito</creatorcontrib><creatorcontrib>Hashiguchi, Kohji</creatorcontrib><creatorcontrib>Funakoshi, Satoshi</creatorcontrib><creatorcontrib>Suyama, Naofumi</creatorcontrib><creatorcontrib>Tanaka, Hikaru</creatorcontrib><creatorcontrib>Yanagihara, Katsunori</creatorcontrib><creatorcontrib>Izumikawa, Koichi</creatorcontrib><creatorcontrib>Mukae, Hiroshi</creatorcontrib><title>Development of a score model to predict long‐term prognosis after community‐onset pneumonia in older patients</title><title>Respirology (Carlton, Vic.)</title><addtitle>Respirology</addtitle><description>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 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.
Conclusion
Patients meeting this score should be considered near the end of life, and the initiation of ACP practices should be considered.
We aimed to identify factors influencing the long‐term prognosis of elderly patients with pneumonia and to develop a prediction score model for the effective initiation of advance care planning. Performance status (PS) ≥2, hypoalbuminemia ≤2.5 g/dL and dementia were significant factors. The scoring model demonstrated 94.6% sensitivity and 61.7% specificity.</description><subject>advance care planning</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>antibiotic resistance</subject><subject>Community-Acquired Infections - diagnosis</subject><subject>Community-Acquired Infections - drug therapy</subject><subject>Community-Acquired Infections - microbiology</subject><subject>community‐acquired pneumonia</subject><subject>Dementia</subject><subject>Dementia - diagnosis</subject><subject>Dementia - epidemiology</subject><subject>Dementia disorders</subject><subject>Female</subject><subject>healthcare‐associated pneumonia</subject><subject>Humans</subject><subject>long‐term prognosis</subject><subject>Male</subject><subject>Multivariate analysis</subject><subject>Pneumonia</subject><subject>Pneumonia - diagnosis</subject><subject>Pneumonia - drug therapy</subject><subject>Pneumonia - microbiology</subject><subject>Pneumonia - mortality</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Sensitivity analysis</subject><issn>1323-7799</issn><issn>1440-1843</issn><issn>1440-1843</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90ctOHiEUB3DS1NRLu-kDGJJuGpOxMMAAS-M9MdH0sp4wzBmDGWCEGc236yP4jD6J6KcuuigbyMkvf07OQegrJfu0nB8J8rRPuRT1B7RFOScVVZx9LG9Ws0pKrTfRds43hBAmiPiENpmSjZZEbqHbI7iDMU4ewozjgA3ONibAPvYw4jniKUHv7IzHGK4f_z7MkHypxesQs8vYDKWAbfR-CW5eFRBDhhlPARYfgzPYBRzHvqDJzK58kj-jjcGMGb683jvoz8nx78Oz6uLy9Pzw4KKyjDZ1RWsB1naCd72GBsjQQC8soV1Dle4sNLXtmKGqEVL0PVdcDLqTehg4k1QZwnbQ93Vu6fZ2gTy33mUL42gCxCW3jIgyBK40LfTbP_QmLimU7opSVBOulShqb61sijknGNopOW_SqqWkfV5E-7yI9mURBe--Ri6dh_6dvk2-ALoG926E1X-i2p_Hv67WoU_y35b6</recordid><startdate>202408</startdate><enddate>202408</enddate><creator>Takazono, Takahiro</creator><creator>Namie, Hotaka</creator><creator>Nagayoshi, Yohsuke</creator><creator>Imamura, Yoshifumi</creator><creator>Ito, Yuya</creator><creator>Sumiyoshi, Makoto</creator><creator>Ashizawa, Nobuyuki</creator><creator>Yoshida, Masataka</creator><creator>Takeda, Kazuaki</creator><creator>Iwanaga, Naoki</creator><creator>Ide, Shotaro</creator><creator>Harada, Yosuke</creator><creator>Hosogaya, Naoki</creator><creator>Takemoto, Shinnosuke</creator><creator>Fukuda, Yuichi</creator><creator>Yamamoto, Kazuko</creator><creator>Miyazaki, Taiga</creator><creator>Sakamoto, Noriho</creator><creator>Obase, Yasushi</creator><creator>Sawai, Toyomitsu</creator><creator>Higashiyama, Yasuhito</creator><creator>Hashiguchi, Kohji</creator><creator>Funakoshi, Satoshi</creator><creator>Suyama, Naofumi</creator><creator>Tanaka, Hikaru</creator><creator>Yanagihara, Katsunori</creator><creator>Izumikawa, Koichi</creator><creator>Mukae, Hiroshi</creator><general>John Wiley & Sons, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7577-476X</orcidid><orcidid>https://orcid.org/0000-0001-8838-7403</orcidid><orcidid>https://orcid.org/0000-0002-0696-5386</orcidid><orcidid>https://orcid.org/0000-0001-7872-8147</orcidid><orcidid>https://orcid.org/0000-0003-1295-4357</orcidid><orcidid>https://orcid.org/0000-0002-1357-1676</orcidid></search><sort><creationdate>202408</creationdate><title>Development of a score model to predict long‐term prognosis after community‐onset pneumonia in older patients</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3162-125eccb54bd9e6e0f6ed5c01b6189bce62cb3a186575dd4845f9b79ff43718a03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>advance care planning</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>antibiotic resistance</topic><topic>Community-Acquired Infections - diagnosis</topic><topic>Community-Acquired Infections - drug therapy</topic><topic>Community-Acquired Infections - microbiology</topic><topic>community‐acquired pneumonia</topic><topic>Dementia</topic><topic>Dementia - diagnosis</topic><topic>Dementia - epidemiology</topic><topic>Dementia disorders</topic><topic>Female</topic><topic>healthcare‐associated pneumonia</topic><topic>Humans</topic><topic>long‐term prognosis</topic><topic>Male</topic><topic>Multivariate analysis</topic><topic>Pneumonia</topic><topic>Pneumonia - diagnosis</topic><topic>Pneumonia - drug therapy</topic><topic>Pneumonia - microbiology</topic><topic>Pneumonia - mortality</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Sensitivity analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Takazono, Takahiro</creatorcontrib><creatorcontrib>Namie, Hotaka</creatorcontrib><creatorcontrib>Nagayoshi, Yohsuke</creatorcontrib><creatorcontrib>Imamura, Yoshifumi</creatorcontrib><creatorcontrib>Ito, Yuya</creatorcontrib><creatorcontrib>Sumiyoshi, Makoto</creatorcontrib><creatorcontrib>Ashizawa, Nobuyuki</creatorcontrib><creatorcontrib>Yoshida, Masataka</creatorcontrib><creatorcontrib>Takeda, Kazuaki</creatorcontrib><creatorcontrib>Iwanaga, Naoki</creatorcontrib><creatorcontrib>Ide, Shotaro</creatorcontrib><creatorcontrib>Harada, Yosuke</creatorcontrib><creatorcontrib>Hosogaya, Naoki</creatorcontrib><creatorcontrib>Takemoto, Shinnosuke</creatorcontrib><creatorcontrib>Fukuda, Yuichi</creatorcontrib><creatorcontrib>Yamamoto, Kazuko</creatorcontrib><creatorcontrib>Miyazaki, Taiga</creatorcontrib><creatorcontrib>Sakamoto, Noriho</creatorcontrib><creatorcontrib>Obase, Yasushi</creatorcontrib><creatorcontrib>Sawai, Toyomitsu</creatorcontrib><creatorcontrib>Higashiyama, Yasuhito</creatorcontrib><creatorcontrib>Hashiguchi, Kohji</creatorcontrib><creatorcontrib>Funakoshi, Satoshi</creatorcontrib><creatorcontrib>Suyama, Naofumi</creatorcontrib><creatorcontrib>Tanaka, Hikaru</creatorcontrib><creatorcontrib>Yanagihara, Katsunori</creatorcontrib><creatorcontrib>Izumikawa, Koichi</creatorcontrib><creatorcontrib>Mukae, Hiroshi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Respirology (Carlton, Vic.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Takazono, Takahiro</au><au>Namie, Hotaka</au><au>Nagayoshi, Yohsuke</au><au>Imamura, Yoshifumi</au><au>Ito, Yuya</au><au>Sumiyoshi, Makoto</au><au>Ashizawa, Nobuyuki</au><au>Yoshida, Masataka</au><au>Takeda, Kazuaki</au><au>Iwanaga, Naoki</au><au>Ide, Shotaro</au><au>Harada, Yosuke</au><au>Hosogaya, Naoki</au><au>Takemoto, Shinnosuke</au><au>Fukuda, Yuichi</au><au>Yamamoto, Kazuko</au><au>Miyazaki, Taiga</au><au>Sakamoto, Noriho</au><au>Obase, Yasushi</au><au>Sawai, Toyomitsu</au><au>Higashiyama, Yasuhito</au><au>Hashiguchi, Kohji</au><au>Funakoshi, Satoshi</au><au>Suyama, Naofumi</au><au>Tanaka, Hikaru</au><au>Yanagihara, Katsunori</au><au>Izumikawa, Koichi</au><au>Mukae, Hiroshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development of a score model to predict long‐term prognosis after community‐onset pneumonia in older patients</atitle><jtitle>Respirology (Carlton, Vic.)</jtitle><addtitle>Respirology</addtitle><date>2024-08</date><risdate>2024</risdate><volume>29</volume><issue>8</issue><spage>722</spage><epage>730</epage><pages>722-730</pages><issn>1323-7799</issn><issn>1440-1843</issn><eissn>1440-1843</eissn><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 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.
Conclusion
Patients meeting this score should be considered near the end of life, and the initiation of ACP practices should be considered.
We aimed to identify factors influencing the long‐term prognosis of elderly patients with pneumonia and to develop a prediction score model for the effective initiation of advance care planning. Performance status (PS) ≥2, hypoalbuminemia ≤2.5 g/dL and dementia were significant factors. The scoring model demonstrated 94.6% sensitivity and 61.7% specificity.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>38769707</pmid><doi>10.1111/resp.14752</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-7577-476X</orcidid><orcidid>https://orcid.org/0000-0001-8838-7403</orcidid><orcidid>https://orcid.org/0000-0002-0696-5386</orcidid><orcidid>https://orcid.org/0000-0001-7872-8147</orcidid><orcidid>https://orcid.org/0000-0003-1295-4357</orcidid><orcidid>https://orcid.org/0000-0002-1357-1676</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1323-7799 |
| ispartof | Respirology (Carlton, Vic.), 2024-08, Vol.29 (8), p.722-730 |
| issn | 1323-7799 1440-1843 1440-1843 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_3057694891 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | advance care planning Aged Aged, 80 and over Anti-Bacterial Agents - therapeutic use antibiotic resistance Community-Acquired Infections - diagnosis Community-Acquired Infections - drug therapy Community-Acquired Infections - microbiology community‐acquired pneumonia Dementia Dementia - diagnosis Dementia - epidemiology Dementia disorders Female healthcare‐associated pneumonia Humans long‐term prognosis Male Multivariate analysis Pneumonia Pneumonia - diagnosis Pneumonia - drug therapy Pneumonia - microbiology Pneumonia - mortality Predictive Value of Tests Prognosis Prospective Studies Risk Factors Sensitivity analysis |
| title | Development of a score model to predict long‐term prognosis after community‐onset pneumonia in older patients |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-26T11%3A50%3A37IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Development%20of%20a%20score%20model%20to%20predict%20long%E2%80%90term%20prognosis%20after%20community%E2%80%90onset%20pneumonia%20in%20older%20patients&rft.jtitle=Respirology%20(Carlton,%20Vic.)&rft.au=Takazono,%20Takahiro&rft.date=2024-08&rft.volume=29&rft.issue=8&rft.spage=722&rft.epage=730&rft.pages=722-730&rft.issn=1323-7799&rft.eissn=1440-1843&rft_id=info:doi/10.1111/resp.14752&rft_dat=%3Cproquest_cross%3E3057694891%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3081904985&rft_id=info:pmid/38769707&rfr_iscdi=true |