Risk factors for the severity and mortality of pneumococcal pneumonia: Importance of premorbid patients' performance status

Ishiguro, Takashi; Kagiyama, Naho; Uozumi, Ryuji; Odashima, Kyuto; Kurashima, Kazuyoshi; Morita, Satoshi; Takayanagi, Noboru

doi:10.1016/j.jiac.2016.07.008

Cited by 20 publications

(15 citation statements)

References 32 publications

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“…L'association entre l'incidence de la pneumonie communautaire et le diabète est retrouvée dans la plupart des études (mais pas toutes). Il est également lié à une augmentation de complications de cette pneumonie (bactériémie, empyème, décès) [22][23][24][25][26][27][28][29][30][31][32][33][34] .…”

Section: Les Infections Respiratoires Bassesunclassified

Association between diabetes mellitus and infection : which evidence for a causal role of hyperglycemia ?

Richard¹,

Buttafuoco²,

Vanhaeverbeek³

et al. 2018

Rev Med Brux

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RESUME L'association statistique entre le diabète et l'infection est en accord avec les observations de la pratique clinique quotidienne et les notions anciennes de la physiopathologie. Dans cet article, nous cherchons à déterminer si, dans cette association, l'hyperglycémie en elle-même constitue un facteur causal. Pour ce faire, nous avons vérifié si cette hypothèse est en accord avec les neuf critères de Bradford-Hill. Nous avons procédé en analysant systématiquement la littérature, en partant d'une liste de tableaux cliniques infectieux définis. Nous avons donc vérifié successivement la force de cette association, sa stabilité, sa spécificité, sa temporalité, l'existence d'un effet dose-réponse, sa plausibilité biologique, la cohérence de l'hypothèse, les données expérimentales et l'existence possible d'analogies. Nous avons ainsi pu identifier les tableaux cliniques concernés, ainsi que les risques relatifs et rapports de cote associés. Nous avons également relevé certaines affections hautement spécifiques du diabète, comme la pyélonéphrite emphysémateuse ou l'otite maligne externe. Nous avons pu voir que l'hypothèse testée s'insère correctement dans les données de la biologie et de l'épidémiologie moderne. Huit des neuf critères de Bradford-Hill étant remplis, il existe effectivement une association causale entre l'hyperglycémie, la glycosurie et l'augmentation du risque d'infection dans le diabète. Rev Med Brux 2018 ; 39 : 495-504 ABSTRACTThe statistical association between diabetes mellitus and infectious diseases is consistent with the observations of daily clinical practice and ancillary notions of pathophysiology. In this issue, we aim to establish whether hyperglycemia itself plays a causal role in this association. To do so, we have verified whether this hypothesis fulfilled the Bradford Hill criteria. We have systematically reviewed the medical literature from a panel of infectious diseases. We have successively verified the strength of the association, its stability, specificity, and temporality, the existence of a dose-response effect, its coherence, the experimental data and available analogy. We could identify the clinical affections of interest and related relative risks and odds ratios. We also have identified several affections highly specific of diabetic patients, such as emphysematous pyelonephritis and malignant external otitis. We could conclude that the the hyperglycemia and glycosuria play a causal role in the relation between diabetes mellitus and the risk of infectious disease. Rev Med Brux 2018 ; 39 : 495-504

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Section: Les Infections Respiratoires Bassesunclassified

Association between diabetes mellitus and infection : which evidence for a causal role of hyperglycemia ?

Richard¹,

Buttafuoco²,

Vanhaeverbeek³

et al. 2018

Rev Med Brux

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“…Japan has been the most rapidly aging society in the world, with a life expectancy of 80.1 years for men and 86.4 years for women 3 . Pneumonia is the third highest cause of death, with most of these deaths among elderly patients 4 .…”

Section: Introductionmentioning

confidence: 99%

Limited Effect of Rehabilitation for Preventing a Decline in Functional Status after Community-Acquired Pneumonia in Elderly Patients

Hao

Horita

et al. 2020

Preprint

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Abstract Background: Functional status is often decreased after hospitalization in elderly community-acquired pneumonia (CAP) survivors. This study investigated factors contributing to decreased functional status.Methods: This retrospective, observational study was conducted in two medical facilities from January 2016 to December 2018. Hospitalized CAP patients >64 years of age were divided into two groups: a maintained group, without decreased functional status, and a decreased group, with decreased functional status. Functional status was evaluated by the Barthel Index (BI) (range, 0–100, in 5-point increments) and graded into three categories: independent, BI 80–100; semi-dependent, BI 30–75; and dependent, BI 0–25. A decreased functional status was considered as a decline of at least one category. The primary outcome was the length of hospital stay. Results: The maintained group included 400 patients, and the decreased group included 138 patients (median age: 77 vs 82 years; p < 0.001). The decreased group had a longer hospital stay (13 vs 27; p<0.001), with a high rate of rehabilitation [189(47.3%) vs 104(75.4%); p<0.001]. Multivariable regression analysis showed that factors affecting functional status were length of hospital stay, aspiration, age, and pneumonia severity index (PSI) category V (odds ratio 1.05, 95%CI 1.04–1.07; 2.66, 95%CI 1.58–4.49; 1.05, 95%CI 1.02–1.09; and 1.92, 95%CI 1.29-3.44; respectively). Rehabilitation showed a limited effect in preventing a decreased functional status on propensity score analysis (p=0.327).Conclusions: Length of hospital stay, aspiration, age, and PSI V were independent contributors to decreased functional status. Rehabilitation showed a limited effect in preventing decreased functional status.

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“…[2] In Japan, pneumonia is the third highest cause of death among elderly patients. [3] Besides the high mortality in elderly CAP patients, these patients also experience deterioration of functional status (FS), an important component of quality of life for older adults and their caregivers, both during and after treatment [4]. Decreased FS prolongs length of stay (LOS) in elderly CAP patients [5], and the prevalence of functional decline was reported to be 8.6%-20% in CAP [5,6].…”

Section: Introductionmentioning

confidence: 99%

Limited effect of rehabilitation for preventing a decrease in functional status after community-acquired pneumonia in elderly patients 

Chen¹,

Hara²,

Horita³

et al. 2020

Preprint

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Background: Functional status (FS) is often decreased after hospitalization in elderly community-acquired pneumonia (CAP) survivors. Rehabilitation has frequently been used to prevent decreased FS. This study was designed to evaluate the effect of rehabilitation for preventing decreased FS.Methods: This retrospective, observational study was conducted in two medical facilities from January 2016 to December 2018, and hospitalized CAP patients >64 years of age were enrolled. FS was assessed by the Barthel Index (BI) (range, 0–100, in 5-point increments) at admission and before discharge and graded into three categories: independent, BI 80–100; semi-dependent, BI 30–75; and dependent, BI 0–25. Multivariable analysis of factors contributing to decreased FS was conducted with two groups: with a decrease of at least one category (decreased group), or without a decrease of a category (maintained group). Then, the effect of rehabilitation was examined by propensity score analysis by adjusting factors contributing to decreased FS determined in the previous multivariable analysis. Results: The maintained group included 400 patients, and the decreased group included 138 patients. The decreased group had a high frequency of rehabilitation therapy (189 (47.3%) vs 104 (75.4%); p<0.001). Multivariable analysis showed that factors affecting FS were length of stay, aspiration pneumonia, age, and Pneumonia Severity Index (PSI) of category V (odds ratio 1.05, 95%CI 1.04–1.07; 2.66, 95%CI 1.58–4.49; 1.05, 95%CI 1.02–1.09; and 1.92, 95%CI 1.29-3.44; respectively). After adjusting for factors contributing to decreased FS, rehabilitation showed a limited effect in preventing a decreased FS in 166 matched pairs (p=0.327).Conclusions: The effect of rehabilitation was still unclear in CAP, and further research is warranted to find an effective way to conduct rehabilitation.

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Risk factors for the severity and mortality of pneumococcal pneumonia: Importance of premorbid patients' performance status

Cited by 20 publications

References 32 publications

Association between diabetes mellitus and infection : which evidence for a causal role of hyperglycemia ?

Association between diabetes mellitus and infection : which evidence for a causal role of hyperglycemia ?

Limited Effect of Rehabilitation for Preventing a Decline in Functional Status after Community-Acquired Pneumonia in Elderly Patients

Limited effect of rehabilitation for preventing a decrease in functional status after community-acquired pneumonia in elderly patients

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Risk factors for the severity and mortality of pneumococcal pneumonia: Importance of premorbid patients' performance status

Cited by 20 publications

References 32 publications

Association between diabetes mellitus and infection : which evidence for a causal role of hyperglycemia ?

Association between diabetes mellitus and infection : which evidence for a causal role of hyperglycemia ?

Limited Effect of Rehabilitation for Preventing a Decline in Functional Status after Community-Acquired Pneumonia in Elderly Patients

Limited effect of rehabilitation for preventing a decrease in functional status after community-acquired pneumonia in elderly patients&nbsp;

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Limited effect of rehabilitation for preventing a decrease in functional status after community-acquired pneumonia in elderly patients