Exploration of Aging-Care Parameters to Predict Mortality of Patients Aged 80-Years and Above with Community-Acquired Pneumonia

Abstract

Chunxin Lv1 *, Wen Shi2 *, Teng Pan,3,4 Houshen Li,5 Weixiong Peng,6 Jiayi Xu,7 Jinhai Deng4,6 1Oncology Department, Punan Hospital of Pudong New District, Shanghai, People’s Republic of China; 2Department of Dermatology, Punan Hospital of Pudong New District, Shanghai, People’s Republic of China; 3The 3rd Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, People’s Republic of China; 4Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King’s College London, London, SE1 1UL, UK; 5Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care King’s College London, London, UK; 6Hunan Zixing Artificial Intelligence Technology Group Co, Ltd, Changsha City, Hunan Province, People’s Republic of China; 7Geriatric Department, Fudan University, Minhang Hospital, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jiayi Xu, Geriatric Department, Fudan University, Minhang Hospital, No. 170, Xinsong Road, Shanghai, 201100, People’s Republic of China, Email [email protected] Jinhai Deng, Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King’s College London, London, SE1 1UL, UK, Tel [phone], Email [email protected]: The study explores a clinical model based on aging-care parameters to predict the mortality of hospitalized patients aged 80-year and above with community-acquired pneumonia (CAP).Patients and methods: In this study, four hundred and thirty-five CAP patients aged 80-years and above were enrolled in the Central Hospital of Minhang District, Shanghai during 01,01,2018– 31,12,2021. The clinical data were collected, including aging-care relevant factors (ALB, FRAIL, Barthel Index and age-adjusted Charlson Comorbidity Index) and other commonly used factors. The prognostic factors were screened by multivariable logistic regression analysis. Receiver operating characteristic (ROC) curves were used to predict the mortality risk.Results: Univariate analysis demonstrated that several factors, including gender, platelet distribution width, NLR, ALB, CRP, pct, pre-albumin, CURB-65, low-density, lipoprotein, Barthel Index, FRAIL, leucocyte count, neutrophil count, lymphocyte count and aCCI, were associated with the prognosis of CAP. Multivariate model analyses further identified that CURB-65 (p < 0.0001, OR = 5.44, 95% CI = 3.021– 10.700), FRAIL (p < 0.0001, OR = 5.441, 95% CI = 2.611– 12.25) and aCCI (p = 0.003, OR = 1.551, 95% CI = 1.165– 2.099) were independent risk factors, whereas ALB (p = 0.005, OR = 0.871, 95% CI = 0.788– 0.957) and Barthel Index (p = 0.0007, OR = 0.958, 95% CI = 0.933– 0.981) were independent protective factors. ROC curves were plotted to further predict the in-hospital mortality and revealed that combination of three parameters (Barthel Index+ FRAI +CURB-65) showed the best performance.Conclusion: This study showed that CURB-65, frailty and aCCI were independent risk factors influencing prognosis. In addition, ALB and Barthel Index were protective factors for in CAP patients over 80-years old. AUC was calculated and revealed that combination of three parameters (Barthel Index+ FRAI +CURB-65) showed the best performance.Keywords: aging care, functional status, frailty, CURB65

Keywords

• aging care
• functional status
• frailty
• curb65.