Valoración geriátrica y factores pronósticos de mortalidad en pacientes muy ancianos con neumonía extrahospitalaria

Calle, Alicia; Márquez, Miguel Ángel; Arellano, Marta; Pérez, Laura Mónica; Pi-Figueras, Maria; Miralles, Ramón

doi:10.1016/j.arbres.2014.01.012

Cited by 29 publications

(14 citation statements)

References 22 publications

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“…66 Predictors of mortality include advanced age (≥90 years), impaired consciousness, anemia, pleural effusion, and multilobar infiltrates. 84 Specific comorbid illnesses including hip fracture, COPD, and cerebrovascular disease also adversely impact 30-day mortality. 85 Elders diagnosed with CAP often have a prolonged recovery, particularly if a history of COPD is present.…”

Section: Pneumonia and Influenzamentioning

confidence: 99%

Sepsis and Other Infectious Disease Emergencies in the Elderly

Liang

2016

Emergency Medicine Clinics of North America

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Section: Pneumonia and Influenzamentioning

confidence: 99%

Sepsis and Other Infectious Disease Emergencies in the Elderly

Liang

2016

Emergency Medicine Clinics of North America

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“…Several studies, suggested that age ≥ 85 years was an independent predictive factor for mortality in patients affected with community acquired pneumonia 26,27 . Calle et al reported that age ≥ 90 years was markedly associated with mortality 28 . Ageing is associated with a progressively weakened immune system and decreased lung performance.…”

Section: Discussionmentioning

confidence: 99%

Age is not the only risk factor in COVID-19: the role of comorbidities and of long staying in residential care homes.

D’Ascanio

Innammorato

Pasquariello

et al. 2020

Preprint

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Background: The actual SARS-CoV-2 outbreak caused a highly transmissible disease with a tremendous impact on elderly people. So far, few studies focused on very elderly patients (over 80 years old). In this study we examined the clinical presentation and the evolution of the disease in this group of patients, admitted to our Hospital in RomeMethods: This is a single-center, retrospective study performed in the Sant’Andrea University Hospital of Rome. We included patients older than 65 years of age with a diagnosis of COVID-19, from March 2020 to may 2020, divided in two groups according to their age (G1 65-80 years old; G2 >80 years old). Data extracted from the each patient record included age, sex, comorbidities, symptoms at onset, the Pneumonia Severity Index (PSI), the ratio of the partial pressure of oxygen in arterial blood (PaO2) to the inspired oxygen fraction (FiO2) (P/F) on admission, laboratory tests, radiological findings on computer tomography (CT), length of hospital stay (LOS), mortality rate and the viral shedding. The differences between the two groups were analyzed by the Fisher’s exact test or the Wilcoxon signed-rank test for categorical variables and the Mann-Whitney U test for continuous variables. The survival time was estimated by Kaplan-Meier method and Log Rank Test. Univariable Cox proportional hazard regression and ordinal logistic regression were performed to estimate associations between age, comorbidities and provenance from residential care homes and clinical outcomes.Results: We found that G2 patients had an increased mortaliy rate, also due to (the frequent prevalence of) multiple comorbidities. Moreover we found that patients coming from long-stay residential care homes appeared to be highly susceptible and vulnerable to develop severe manifestations of the disease.Conclusion: We demonstrate that there were considerable differences between Elderly and Very Elderly patients in terms of inflammatory activity, severity of disease, adverse clinical outcomes; moreover, to establish a correct risk stratification, comorbidities and information about provenience from residential care homes should be considered.

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“…Se ha demostrado que el deterioro de cada una de estas áreas puede ser un factor independiente de mortalidad en ancianos con NAC. 1,3,10 El uso de herramientas para valorar severidad ha sido ampliamente adoptado como parte del abordaje inicial de NAC y es clave para la toma de decisiones iniciales. Parte de su utilidad radica en definir si el manejo será ambulatorio u hospitalario, así como para orientar la ruta de administración de la antibioticoterapia y el pronóstico.…”

Section: Estratificación Pronóstica Y Estabilidad Clínicaunclassified

“…27 Si bien estas escalas de estratificación de la gravedad son muy utilizadas, se deben considerar otros factores cuando se decide si el manejo apropiado es el ambulatorio o si amerita hospitalización. 1,28 Por esto, la VGI es importante al decidir los procedimientos diagnósticos y terapéuticos, así como al decidir el ingreso hospitalario y definir el nivel asistencial más adecuado. 1,29 Los sitios hospitalarios en que pueden tratarse pacientes con NAC son: unidades de observación, unidades de corta estancia, hospitalización convencional o unidades de cuidado intensivo.…”

Section: Estratificación Pronóstica Y Estabilidad Clínicaunclassified

“…1,28 Por esto, la VGI es importante al decidir los procedimientos diagnósticos y terapéuticos, así como al decidir el ingreso hospitalario y definir el nivel asistencial más adecuado. 1,29 Los sitios hospitalarios en que pueden tratarse pacientes con NAC son: unidades de observación, unidades de corta estancia, hospitalización convencional o unidades de cuidado intensivo. 30 Ha habido interés en el uso de biomarcadores en NAC.…”

Section: Estratificación Pronóstica Y Estabilidad Clínicaunclassified

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