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Cited 3 time in webofscience Cited 4 time in scopus
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Functional status recovery trajectories in hospitalised older adults with pneumoniaopen access

Authors
Park, Chan MiDhawan, RaviLie, Jessica J.Sison, Stephanie M.Kim, WonsockLee, Eun SikKim, Jong HunKim, Dae Hyun
Issue Date
May-2022
Publisher
British Thoracic Society | BMJ Publishing Group Ltd
Keywords
Pneumonia; Clinical Epidemiology
Citation
BMJ Open Respiratory Research, v.9, no.1
Indexed
SCIE
SCOPUS
Journal Title
BMJ Open Respiratory Research
Volume
9
Number
1
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/60977
DOI
10.1136/bmjresp-2022-001233
ISSN
2052-4439
2052-4439
Abstract
Background and objectives Pneumonia is associated with significant mortality and morbidity in older adults. We investigated changes in functional status over 6 months after pneumonia hospitalisation by frailty status. Methods and measurements This single-centre prospective cohort study enrolled 201 patients (mean age 79.4, 37.3% women) who were hospitalised with pneumonia. A deficit-accumulation frailty index (range: 0–1; robust <0.15, pre-frail 0.15–0.24, mild-to-moderately frail 0.25–0.44, severely frail ≥0.45) was calculated on admission. Functional status, defined as self-reported ability to perform 21 activities and physical tasks independently, was measured by telephone at 1, 3 and 6 months after discharge. Group-based trajectory model was used to identify functional trajectories. We examined the probability of each trajectory based on frailty levels. Results On admission, 51 (25.4%) were robust, 43 (21.4%) pre-frail, 40 (20.0%) mild-to-moderately frail and 67 (33.3%) severely frail patients. Four trajectories were identified: excellent (14.4%), good (25.4%), poor (28.9%) and very poor (31.3%). The trajectory was more strongly correlated with frailty level on admission than pneumonia severity. The most common trajectory was excellent trajectory (59.9%) in robust patients, good trajectory (74.4%) in pre-frail patients, poor trajectory (85.0%) in mild-to-moderately frail patients and very poor trajectory (89.6%) in severely frail patients. The risk of poor or very poor trajectory from robust to severely frail patients was 11.8%, 25.6%, 92.5% and 100%, respectively. Conclusions Frailty was a strong determinant of lack of functional recovery over 6 months after pneumonia hospitalisation in older adults. Our results call for hospital-based and post-acute care interventions for frail patients.
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