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Cited 5 time in webofscience Cited 5 time in scopus
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Comparison of Frailty Index to Pneumonia Severity Measures in Older Patients With Pneumonia

Authors
Park, Chan MiKim, WonsockLee, Eun SikRhim, Hye ChangCho, Kyung HwanKim, Jong HunKim, Dae Hyun
Issue Date
Jan-2022
Publisher
Lippincott Williams & Wilkins Ltd.
Keywords
Frailty; functional status; CURB-65; PSI
Citation
Journal of the American Medical Directors Association, v.23, no.1, pp 165 - 169
Pages
5
Indexed
SCIE
SCOPUS
Journal Title
Journal of the American Medical Directors Association
Volume
23
Number
1
Start Page
165
End Page
169
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/55232
DOI
10.1016/j.jamda.2021.08.044
ISSN
1525-8610
1538-9375
Abstract
Objectives: Risk stratification tools are useful to provide appropriate clinical care for older patients with pneumonia. This study aimed to compare a Frailty Index (FI) with pneumonia severity measures, CURB-65, and the Pneumonia Severity Index (PSI), for predicting mortality and persistent disability after pneumonia. Design: Single-center prospective cohort study. Setting and Participants: The study included 190 patients aged >= 65 years who were hospitalized with pneumonia at a university hospital in Korea between October 2019 and September 2020. Methods: At admission, a 50-item deficit-accumulation FI (range: 0-1), CURB-65 (range: 0-5), and PSI (range: 0-395) scores were calculated. The outcomes were death and a composite outcome of death or decline in ability to perform daily activities and physical task 6 months later. Results: The median age was 79 years (interquartile range: 74-85), and 70 (36.8%) patients were women. The patients who died (n = 53) had higher FI (median, 0.46 vs 0.20; P <.011), CURB- 65 score (median, 3 vs 2; P=.001), and PSI score (median, 149 vs 116; P <.001) than those who did not. The C-statistics (95% confidence intervals) for 6-month mortality were 0.69 (0.61-0.77) for the FI, 0.62 (0.53-0.71) for CURB-65, and 0.71 (0.62-0.79) for the PSI (P=.019). The C-statistics for the 6-month composite outcome were 0.73 (0.65-0.81) for the FI, 0.64 (0.55-0.73) for CURB-65, and 0.69 (0.60-0.77) for the PSI (P=.096). The C-statistics improved when the FI was added to CURB-65 (from 0.64 to 0.74; P=.003) and to the PSI (from 0.69 to 0.75; P=.044) for the composite outcome. Conclusions and Implications: Measuring frailty provides additive value to widely used pneumonia severity measures in predicting death or persistent hospitalization-associated disability in older adults after pneumonia hospitalization. Early recognition of frailty may be useful to identify those who require in-hospital and post-acute care interventions for functional recovery. (C) 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
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Cho, Kyung Hwan
Anam Hospital (Department of Family Medicine, Anam Hospital)
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