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

被引：19

作者：

Corrao, S. ^{[1
,2
]}

Argano, C. ^{[3
]}

Natoli, G. ^{[2
]}

Nobili, A. ^{[4
]}

Corazza, G. R. ^{[5
,6
]}

Mannucci, P. M. ^{[7
]}

Perticone, F. ^{[8
]}

Prisco, Domenico ^{[9
]}

Silvestri, Elena ^{[9
]}

Emmi, Giacomo ^{[9
]}

Bettiol, Alessandra ^{[9
]}

Caterina, Cenci ^{[9
]}

Biolo, Gianni ^{[10
]}

Zanetti, Michela ^{[10
]}

Guadagni, Martina ^{[10
]}

Zaccari, Michele ^{[1
,10
]}

Chiuch, Massimiliano ^{[10
]}

Zaccari, Michele ^{[1
,10
]}

Vanoli, Massimo ^{[11
]}

Grignani, Giulia ^{[11
]}

Pulixi, Edoardo Alessandro ^{[11
]}

Bernardi, Mauro ^{[12
]}

Bassi, Silvia Li ^{[12
]}

Santi, Luca ^{[12
]}

Zaccherini, Giacomo ^{[12
]}

Lupattelli, Graziana ^{[13
]}

Mannarino, Elmo ^{[13
]}

Bianconi, Vanessa ^{[13
]}

Paciullo, Francesco ^{[13
]}

Alcidi, Riccardo ^{[13
]}

Nuti, Ranuccio ^{[14
]}

Valenti, Roberto ^{[14
]}

Ruvio, Martina ^{[14
]}

Cappelli, Silvia ^{[14
]}

Palazzuoli, Alberto ^{[14
]}

Girelli, Domenico ^{[15
]}

Busti, Fabiana ^{[15
]}

Marchi, Giacomo ^{[15
]}

Barbagallo, Mario ^{[16
]}

Dominguez, Ligia ^{[16
]}

Cocita, Floriana ^{[16
]}

Beneduce, Vincenza ^{[16
]}

Plances, Lidia ^{[16
]}

Corrao, Salvatore ^{[17
]}

Natoli, Giuseppe ^{[17
]}

Mularo, Salvatore ^{[17
]}

Raspanti, Massimo ^{[17
]}

Cavallaro, Federica ^{[17
]}

Zoli, Marco ^{[18
]}

Lazzari, Ilaria ^{[18
]}

机构：

[1] Univ Palermo, Dipartimento Biomed Med Intern & Specialist DiBiM, Palermo, Italy

[2] Euromediterranean Inst Sci & Technol IEMEST, Palermo, Italy

[3] Osped Riuniti Villa Sofia Cervello, Internal Med Dept, PO Villa Sofia, Palermo, Italy

[4] IRCCS Ist Ric Farmacol Mario Negri, Dept Neurosci, Milan, Italy

[5] Univ Pavia, Dept Internal Med, Pavia, Italy

[6] San Matteo Hosp, Pavia, Italy

[7] IRCCS Fdn Maggiore Policlin Hosp, Sci Direct, Milan, Italy

[8] Magna Graecia Univ Catanzaro, Dept Med & Surg Sci, Catanzaro, Italy

[9] Azienda Osped Univ Careggi Firenze, Med Interna Interdisciplinare, Florence, Italy

[10] Azienda Sanitaria Univ Integrata Trieste, Clin Med Gen & Terapia Med, Trieste, Italy

[11] Osped Merate, Azienda Osped Prov Lecco, Med Interna, Lecce, Italy

[12] Azienda Osped Policlin St Orsola Malpighi, Semeiot Med Bernardi, Bologna, Italy

[13] Azienda Osped Santa Maria Misericordia, Med Interna, Perugia, Italy

[14] Azienda Osped Univ Senese, Med Interna 1, Siena, Italy

[15] Azienda Osped Univ Integrata Verona, Med Gen & Malattie Aterotrombot Degenerat, Verona, Italy

[16] Azienda Osped Univ, Policlin Giaccone, Policlin Palermo, Unita Operat Geriatria & Lungodegenza, Palermo, Italy

[17] UOC Med Interna Indirizzo Geriatr Riabilitat, ARNAS Civ, Palermo, Italy

[18] Azienda Osped Univ, Policlin S Orsola Malpighi, Unita Operat Med Interna, Bologna, Italy

[19] Azienda Osped Univ Senese, Unita Operat Complessa Med 2, Siena, Italy

[20] Azienda Osped Univ Consorziale, Policlin Bari, Med Interna Osped L DAgostino, Med Interna Univ A Murri, Bari, Italy

[21] Osped Maggiore Policlin, Unita Operat Med Interna IA, Fdn IRCCS Ca Granda, Milan, Italy

[22] Osped Maggiore Policlin, Geriatria, Fdn IRCCS Ca Granda, Milan, Italy

[23] IRCCS Policlin San Matteo Pavia, Clin Med 1, Reparto 11, Pavia, Italy

[24] IRCCS Azienda Osped Univ San Martino IST Genova, Clin Med Interna 2, Genoa, Italy

[25] Osped Bassini Cinisello Balsamo, Div Med, Milan, Italy

[26] Osped Civile Jazzolino Vibo Valentia, Med Interna, Vibo Valentia, Italy

[27] Osped Clinicizzato SS, Clin Med, Chieti, Italy

[28] Osped Giovanni Paolo II Lamezia Terme, Unita Operat Complessa Med Interna, Catanzaro, Italy

[29] Azienda Osped Univ Sassari, Clin Med, Sassari, Italy

[30] Sapienza Univ Roma, Policlin Umberto I, Med Interna & Nutr Clin Policlin Umberto I, Rome, Italy

[31] Policlin Univ A Gemelli, Unita Operat Complessa Med Urgenza & Pronto Socco, Rome, Italy

[32] Spedali Civili Brescia, Geriatr, Brescia, Italy

[33] Univ Campus Biomed, Med Clin Epatol, Rome, Italy

[34] Univ Milano Bicocca, Osped S Gerardo, Unita Operat Geriatria, Monza, Italy

[35] Univ Magna Grecia, Policlin Mater Domini, Unita Operat Complessa Med Interna, Catanzaro, Italy

[36] Azienda Osped Cardinale Panico Tricase, Unita Operat Complessa Med, Lecce, Italy

[37] Azienda Osped Osped San Camillo Forlanini, Med Interna 1, Rome, Italy

[38] Azienda Osped Papa Giovanni XXIII, Med 1, Bergamo, Italy

[39] Azienda Osped Univ Padova, Clin Med 1, Padua, Italy

[40] Azienda Osped Univ St Anna, Unita Operat Clin Med, Ferrara, Italy

[41] Seconda Univ Studi Napoli, Azienda Osped Univ, Div Med Interna & Malattie Nutr Invecchiamento 4, Naples, Italy

[42] Azienda Osped Univ Consorziale, Policlin Bari, Med Interna Univ C Frugoni, Bari, Italy

[43] Azienda Sanit Osped Santa Croce & Carle Cunco, SC Med Interna, Cuneo, Italy

[44] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Med Interna 1B, Milan, Italy

[45] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, UOC Med Gen Emostatsi & Trombosi, Milan, Italy

[46] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Med Interna Alta Intens, Milan, Italy

[47] IRCCS Policlin San Donato, Milan, Italy

[48] Univ Milan, Med Interna, Milan, Italy

[49] Univ Genoa, Med Interna 1, Genoa, Italy

[50] Osped Casorate Primo, ASST Pavia, UOSD Med Interna, Pavia, Italy

来源：

EUROPEAN JOURNAL OF INTERNAL MEDICINE | 2018年 / 54卷

关键词：

Pneumonia; Elderly; Disability; Diabetes; Comorbidity; COMMUNITY-ACQUIRED PNEUMONIA; ELDERLY-PATIENTS; RISK-FACTORS; 1-YEAR MORTALITY; HYPERGLYCEMIA; ASSOCIATION; ADMISSION;

D O I：

10.1016/j.ejim.2018.04.012

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：53 / 59

页数：7

共 28 条

[1] Incidence, timing and risk factors associated with 1-year mortality after hospitalization for community-acquired pneumonia [J].

Adamuz, Jordi ;

Viasus, Diego ;

Jimenez-Martinez, Emilio ;

Isla, Pilar ;

Garcia-Vidal, Carolina ;

Dorca, Jordi ;

Carratala, Jordi .

JOURNAL OF INFECTION, 2014, 68 (06) :534-541

[2] Factors predictive of outcome on admission to an acute geriatric ward [J].

Alarcón, T ;

Bárcena, A ;

González-Montalvo, JI ;

Peñalosa, C ;

Salgado, A .

AGE AND AGEING, 1999, 28 (05) :429-432

[3] Watch out for diabetes: Less education but let's get moving, let's eat less! [J].

Argano, Christiano ;

Bocchio, Raffaella Mallaci ;

Corrao, Salvatore .

EUROPEAN JOURNAL OF INTERNAL MEDICINE, 2016, 32 :E15-E16

[4] Influence of diabetes and hyperglycaemia on infectious disease hospitalisation and outcome [J].

Benfield, T. ;

Jensen, J. S. ;

Nordestgaard, B. G. .

DIABETOLOGIA, 2007, 50 (03) :549-554

[5] Gender-differences in disease distribution and outcome in hospitalized elderly: Data from the REPOSI study [J].

Corrao, S. ;

Santalucia, P. ;

Argano, C. ;

Djade, C. D. ;

Barone, E. ;

Tettamanti, M. ;

Pasina, L. ;

Franchi, C. ;

Eldin, T. Kamal ;

Marengoni, A. ;

Salerno, F. ;

Marcucci, M. ;

Mannucci, P. M. ;

Nobili, A. .

EUROPEAN JOURNAL OF INTERNAL MEDICINE, 2014, 25 (07) :617-623

[6] Dysglycaemia and 90 day and 1 year risks of death or readmission in patients hospitalised for community-acquired pneumonia [J].

Eurich, D. T. ;

Gamble, J. M. ;

Marrie, T. J. ;

Majumdar, S. R. .

DIABETOLOGIA, 2010, 53 (03) :497-503

[7] Hospitalization for Pneumonia is Associated With Decreased 1-Year Survival in Patients With Type 2 Diabetes Results From a Prospective Cohort Study [J].

Falcone, Marco ;

Tiseo, Giusy ;

Russo, Alessandro ;

Giordo, Laura ;

Manzini, Elisa ;

Bertazzoni, Giuliano ;

Palange, Paolo ;

Taliani, Gloria ;

Cangemi, Roberto ;

Farcomeni, Alessio ;

Vullo, Vincenzo ;

Violi, Francesco ;

Venditti, Mario .

MEDICINE, 2016, 95 (05) :1-8

[8] Association of comorbidity with disability in older women: The Women's Health and Aging Study [J].

Fried, LP ;

Bandeen-Roche, K ;

Kaser, JD ;

Guralnik, JM .

JOURNAL OF CLINICAL EPIDEMIOLOGY, 1999, 52 (01) :27-37

[9] Risk factors for hospital readmissions in elderly patients: a systematic review [J].

Garcia-Perez, L. ;

Linertova, R. ;

Lorenzo-Riera, A. ;

Vazquez-Diaz, J. R. ;

Duque-Gonzalez, B. ;

Sarria-Santamera, A. .

QJM-AN INTERNATIONAL JOURNAL OF MEDICINE, 2011, 104 (08) :639-651

[10]

HICKIE C, 1987, Clinical Gerontologist, V6, P51

← 1 2 3 →