Diagnostic accuracy of activities of daily living in prediction of community-acquired pneumonia outcomes in elderly patients admitted to intensive care units

Abd‐El‐Gawad, Wafaa Mostafa; Adly, Nermien Naim; Salem, Hala M.

doi:10.1016/j.jcgg.2013.08.004

Cited by 5 publications

(10 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…26 Activities of daily living were also reported to be an independent predictor of mortality in patients aged >60 years with CAP. 27 Interestingly, however, our results showed that in-hospital mortality was associated with the need for organ support, such as mechanical ventilation and hemodialysis, at ICU admission, but not with being bedridden or a nursing home resident. Moreover, mortality rates did not differ significantly in patients aged ≥90 years and those aged ≥80 years.…”

Section: Discussioncontrasting

confidence: 56%

Mortality and Prognostic Prediction in Very Elderly Patients With Severe Pneumonia

Baek

Park

Choi

et al. 2019

J Intensive Care Med

View full text Add to dashboard Cite

Introduction: Although prognostic prediction scores for pneumonia such as CURB-65 score or pneumonia severity index (PSI) are widely used, there were a few studies in very elderly patients. The aim of the study was to validate prognostic prediction scores for severe pneumonia and investigate risk factors associated with in-hospital mortality of severe pneumonia in very elderly patients. Methods: During the 6-year study period (from October 2012 to May 2018), 160 patients aged 80 or older admitted to medical intensive unit were analyzed retrospectively. Pneumonia severity was evaluated using CURB-65 score, PSI, Sequential Organ Failure Assessment (SOFA) scores, A-DROP, I-ROAD, UBMo index, SOAR score, and lactate. The outcome was in-hospital mortality. Results: The median age was 85 years (interquartile range: 82-88). Nursing home residents accounted for 71 (44.4%) and in-hospital mortality was 40 (25.0%). Logistic regression showed that chronic lung, mechanical ventilation, hemodialysis, and albumin were associated with in-hospital mortality of pneumonia. Using the receiver operating characteristics curve for predicting mortality, the area under the curve in pneumonia was 0.65 for the SOFA score, 0.61 for the CURB-65 score, 0.52 for the PSI, 0.58 for the A-DROP, 0.52 for the I-ROAD, 0.54 for UBMo index, 0.59 for SOAR score, and 0.65 for lactate. Conclusion: The performances of the CURB-65 and PSI are not excellent in very elderly patients with pneumonia. Further studies are needed to improve the performance of prognostic prediction scores in elderly patients.

show abstract

Section: Discussioncontrasting

confidence: 56%

Mortality and Prognostic Prediction in Very Elderly Patients With Severe Pneumonia

Baek

Park

Choi

et al. 2019

J Intensive Care Med

View full text Add to dashboard Cite

show abstract

“…The eligible 11 studies were published between 2008 and 2019, with a total of 3740 patients from 7 LMICs. Eight studies were conducted in Africa (Malawi [ 18 , 19 , 34 ], Nigeria [ 30 ], South Africa [ 29 , 33 ], Uganda [ 17 ] and Egypt [ 35 ]), and three were from South Asia (Pakistan [ 32 ] and India [ 31 , 36 ]). The average age of the patients ranged from 34 to 69.9 years, and male percentage varied between 38.6% and 62.1%.…”

Section: Resultsmentioning

confidence: 99%

“…Most of identified studies assessed patients in medical wards, emergency departments or outpatient settings. Only one study exclusively evaluated elderly patients (≥60 years) admitted to ICU [ 35 ]. A total of 12 scores, CURB-65 [ 30 , 31 , 32 , 33 , 34 , 35 ], CRB-65 [ 19 , 29 , 30 , 32 , 33 , 34 ], PSI [ 31 , 36 ], SWAT-Bp [ 18 , 19 , 34 ], CURB-45 [ 33 ], SCAP [ 35 ], ADL score [ 35 ], modified IDSA/ATS criteria [ 34 ], Koss et al tool [ 17 ], CTA [ 33 ], ACHU [ 33 ] and SMRT-CO [ 34 ], were examined in these 11 studies, 7 of which reviewed the performance of more than one score [ 19 , 30 , 31 , 32 , 33 , 34 , 35 ].…”

Section: Resultsmentioning

confidence: 99%

“…A total of 12 scores, CURB-65 [ 30 , 31 , 32 , 33 , 34 , 35 ], CRB-65 [ 19 , 29 , 30 , 32 , 33 , 34 ], PSI [ 31 , 36 ], SWAT-Bp [ 18 , 19 , 34 ], CURB-45 [ 33 ], SCAP [ 35 ], ADL score [ 35 ], modified IDSA/ATS criteria [ 34 ], Koss et al tool [ 17 ], CTA [ 33 ], ACHU [ 33 ] and SMRT-CO [ 34 ], were examined in these 11 studies, 7 of which reviewed the performance of more than one score [ 19 , 30 , 31 , 32 , 33 , 34 , 35 ]. All studies addressed mortality as either in-hospital [ 18 , 19 , 33 ], 30-day [ 17 , 30 , 32 , 34 , 35 ], in-hospital or within 30 days of discharge [ 31 , 36 ] or in-hospital or within 14 days following emergency department visit for those discharged earlier [ 29 ]. Four studies included other outcomes (ICU admission [ 30 , 31 ], mechanical ventilation [ 35 ], hospitalisation and time to clini...…”

Section: Resultsmentioning

confidence: 99%

“…All studies addressed mortality as either in-hospital [ 18 , 19 , 33 ], 30-day [ 17 , 30 , 32 , 34 , 35 ], in-hospital or within 30 days of discharge [ 31 , 36 ] or in-hospital or within 14 days following emergency department visit for those discharged earlier [ 29 ]. Four studies included other outcomes (ICU admission [ 30 , 31 ], mechanical ventilation [ 35 ], hospitalisation and time to clinical stability [ 29 ]). Table 1 summarises the studies characteristics (additional characteristics in the Supplementary Materials (Table S1) ).…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Validity of Pneumonia Severity Assessment Scores in Africa and South Asia: A Systematic Review and Meta-Analysis

et al. 2021

View full text Add to dashboard Cite

Background: Although community-acquired pneumonia (CAP) severity assessment scores are widely used, their validity in low- and middle-income countries (LMICs) is not well defined. We aimed to investigate the validity and performance of the existing scores among adults in LMICs (Africa and South Asia). Methods: Medline, Embase, Cochrane Central Register of Controlled Trials, Scopus and Web of Science were searched to 21 May 2020. Studies evaluating a pneumonia severity score/tool among adults in these countries were included. A bivariate random-effects meta-analysis was performed to examine the scores’ performance in predicting mortality. Results: Of 9900 records, 11 studies were eligible, covering 12 tools. Only CURB-65 (Confusion, Urea, Respiratory Rate, Blood Pressure, Age ≥65 years) and CRB-65 (Confusion, Respiratory Rate, Blood Pressure, Age ≥65 years) were included in the meta-analysis. Both scores were effective in predicting mortality risk. Performance characteristics (with 95% Confidence Interval (CI)) at high (CURB-65 ≥ 3, CRB-65 ≥ 3) and intermediate-risk (CURB-65 ≥ 2, CRB-65 ≥ 1) cut-offs were as follows: pooled sensitivity, for CURB-65, 0.70 (95% CI = 0.25–0.94) and 0.96 (95% CI = 0.49–1.00), and for CRB-65, 0.09 (95% CI = 0.01–0.48) and 0.93 (95% CI = 0.50–0.99); pooled specificity, for CURB-65, 0.90 (95% CI = 0.73–0.96) and 0.64 (95% CI = 0.45–0.79), and for CRB-65, 0.99 (95% CI = 0.95–1.00) and 0.43 (95% CI = 0.24–0.64). Conclusions: CURB-65 and CRB-65 appear to be valid for predicting mortality in LMICs. CRB-65 may be employed where urea levels are unavailable. There is a lack of robust evidence regarding other scores, including the Pneumonia Severity Index (PSI).

show abstract

Assessment of impairment and activity limitations in the critically ill: a systematic review of measurement instruments and their clinimetric properties

et al. 2015

View full text Add to dashboard Cite

There is considerable variability in the type of measures utilized to measure physical impairments and limitations in survivors of critical illness. Future work should identify a core set of standardized measures, which can be utilized across the continuum of critical illness recovery embedded within the International Classification of Functioning framework. This will enable improved comparisons between future studies, which in turn will assist in identifying the most effective treatment strategies to ameliorate the devastating longer-term outcomes of a critical illness.

show abstract

Diagnostic accuracy of activities of daily living in prediction of community-acquired pneumonia outcomes in elderly patients admitted to intensive care units

Cited by 5 publications

References 27 publications

Mortality and Prognostic Prediction in Very Elderly Patients With Severe Pneumonia

Mortality and Prognostic Prediction in Very Elderly Patients With Severe Pneumonia

Validity of Pneumonia Severity Assessment Scores in Africa and South Asia: A Systematic Review and Meta-Analysis

Assessment of impairment and activity limitations in the critically ill: a systematic review of measurement instruments and their clinimetric properties

Contact Info

Product

Resources

About