Impact of Frailty Risk on Oral Intake and Length of Hospital Stay in Older Patients with Pneumonia: A Historical Cohort Study

Hori, Shinsuke; Yamamoto, Yoshinori; Ushida, Kenta; Shirai, Yuka; Shimizu, Miho; Kato, Yuki; Shimizu, Akio; Momosaki, Ryo

doi:10.3390/jcm12010077

Cited by 5 publications

(3 citation statements)

References 30 publications

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“…A similar trend was observed for hospital admissions for acute myocardial infarctions and heart failure 32 . More recently, a 2023 Japanese study also demonstrated the association of higher HFRS scores with higher rates of prolonged hospitalization (LOS > 15 days and LOS > 30 days) amongst 98 420 patients with pneumonia 33 . A local study of 902 patients admitted to a tertiary hospital also demonstrated that patients with delirium had higher HFRS scores and had greater 30‐day mortality (OR 2.52) and 30‐day readmission (OR 2.18) 21 .…”

Section: Discussionsupporting

confidence: 58%

“…32 More recently, a 2023 Japanese study also demonstrated the association of higher HFRS scores with higher rates of prolonged hospitalization (LOS > 15 days and LOS > 30 days) amongst 98 420 patients with pneumonia. 33 A local study of 902 patients admitted to a tertiary hospital also demonstrated that patients with delirium had higher HFRS scores and had greater 30-day mortality (OR 2.52) and 30-day readmission (OR 2.18). 21 Patients with delirium were also shown to have a higher prevalence of infections such as pneumonia (37.7% vs. 25.3%).…”

Section: Discussionmentioning

confidence: 97%

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Validation of the Hospital Frailty Risk Score in older adults hospitalized with community‐acquired pneumonia

Rosario,

Quah,

Chang

et al. 2023

Geriatrics Gerontology Int

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AimFrailty results from age‐associated declines in physiological reserve and function and is prevalent in older people. Our aim is to examine the association of the Hospital Frailty Risk Score (HFRS) with adverse events in older patients hospitalized with community‐acquired pneumonia (CAP) and hypothesise that frailty is a comparable predictor of outcomes in CAP versus traditional severity indices such as CURB‐65.MethodsRetrospective review of electronic medical records in patients ≥65 years with CAP admitted to a tertiary hospital from 1 January to 30 April 2021. Patients were identified using ICD codes for CAP and categorized as high risk (>15), intermediate risk (5–15) and low risk (<5) of frailty using the HFRS.ResultsOf 429 patients with CAP, 53.8% male, mean age of 82.9 years, older patients (85 vs. 79.7 years, P < 0.001) were at higher risk of frailty. Using the HFRS, 47.6% were deemed at high risk, 35.9% at intermediate risk, and 16.6% at low risk of frailty. Multivariate logistic regression shows that HFRS was more strongly associated (≥7 days, OR 1.042, CI 1.017–1.069) than CURB‐65 (OR 0.995, CI 0.810–1.222) with long hospital length of stay (LOS), while CURB‐65 (Confusion, Urea >7mmol/L, Respiratory rate >30, Blood pressure, age => 65 years old) was more strongly associated with mortality at 30, 90 and 365 days, compared with the HFRS. Comparing the values for the area under the receiver operator characteristic curve, the HFRS was found to be a better predictor of long LOS, while CURB‐65 remains a better predictor of mortality.ConclusionsPatients with high risk of frailty have higher healthcare utilization and HFRS is a better predictor of long LOS than CURB‐65 but CURB‐65 was a better predictor of mortality. Geriatr Gerontol Int 2023; ••: ••–••.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 97%

Validation of the Hospital Frailty Risk Score in older adults hospitalized with community‐acquired pneumonia

Rosario,

Quah,

Chang

et al. 2023

Geriatrics Gerontology Int

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“…Nutrition has been well-studied in in-hospital patients with CAP for its relationship with frailty [ 30 ] and dysphagia [ 31 ] and as a risk factor for poor outcomes [ 32 ]. Nevertheless, little is known about nutritional status in older adults after CAP discharge except in relation to COVID-19 pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Malnutrition, Functional Decline, and Institutionalization in Older Adults after Hospital Discharge Following Community-Acquired Pneumonia

Clotet-Vidal,

Saez Prieto,

Duch Llorach

et al. 2023

Nutrients

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Background and aims: Community-acquired pneumonia (CAP) is a major threat to older adults, but mid-term implications are poorly described. The aim was to analyze functional decline, institutionalization, malnutrition, and risk factors after hospital admission for CAP. Methods: This prospective observational study included patients over 65 years discharged after CAP between May 2019 and July 2021. We performed a comprehensive geriatric assessment and a general nutritional assessment 30–60 days after CAP. This included the MNA and blood test with trace elements and vitamins. The main outcomes were functional decline, institutionalization, and malnutrition. Multivariate logistic regression was used for the analyses. Results: In total, 144 patients of 77.15 ± 7.91 years, 55.6% male, and 9% previously institutionalized were analyzed. At hospital admission, the Charlson Comorbidity Index (CCI) was 1.5 ± 1.6, the Pneumonia Severity Index was 98.1 ± 25.9, and the previous Barthel Index (BI) was 93.06 ± 17.13. Hospital stay was 9.72 ± 7.88 days. After 44.6 ± 14.4 days, 48.6% patients showed functional decline and 19.4% were institutionalized. Age (OR 1.17; CI 95% 1.09–1.26), previous institutionalization (29.1; 3.7–224.7), BI (1.09; 1.05–1.14), CCI (1.5; 1.1–2.1), and length of stay (1.1, 1.02–1.18) were independently associated with functional decline. The only predictors of new institutionalization were previous BI (0.96; 0.93–0.99) and length of stay (1.06; 1.00–1.13). The MNA indicated malnutrition in 28% of the community-dwelling patients and 67.9% of those institutionalized, with risk of malnutrition being 45.7% and 9.5%, respectively, after an average of 44.6 days of CAP diagnosis. The predictors of malnutrition were previous institutionalization (10.62; 2.20–51.21), BI (0.95; 0.92–0.98), and length of stay (1.12; 1.04–1.20). Micronutrient deficiencies were mainly zinc (61.8%), vitamin D (54.5%), and vitamin C (45.1%). An MNA score < 17 points or hypoalbuminemia showed good specificity to identify these deficiencies. Conclusions: After CAP admission, functional decline, institutionalization, and malnutrition rates were high. Longer hospital stay was a common risk factor for all outcomes. The presence of hypoalbuminemia or an MNA < 17 in older patients should prompt suspicion of deficiencies in micronutrients, such as vitamin D, C, and zinc.

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Oral Health and Frailty

Hogue,

Castrejón-Pérez

2024

Frailty

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Impact of Frailty Risk on Oral Intake and Length of Hospital Stay in Older Patients with Pneumonia: A Historical Cohort Study

Cited by 5 publications

References 30 publications

Validation of the Hospital Frailty Risk Score in older adults hospitalized with community‐acquired pneumonia

Validation of the Hospital Frailty Risk Score in older adults hospitalized with community‐acquired pneumonia

Malnutrition, Functional Decline, and Institutionalization in Older Adults after Hospital Discharge Following Community-Acquired Pneumonia

Oral Health and Frailty

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