title: Functional status as a risk factor for mortality in very elderly patients with pneumonia.
abstract: OBJECTIVE
  The most commonly used prognostic mortality indexes for pneumonia take into account several variables including comorbidities, physical examination results, and laboratory test results, as well as age. Other factors such as functional status are not included. The objective of this study was to know whether the preadmission functional status was related to 30-day mortality in old or very old patients who were hospitalized for pneumonia.
  
  
  METHODS
  This was a prospective study including all patients who were hospitalized for pneumonia in the Acute Geriatric Unit of Hospital de Mataró, Barcelona. We calculated the Pneumonia Severity Index (PSI), preadmission and admission Barthel Index (BI), Charlson Comorbidity Index and Mini Nutritional Assessment (MNA). Patients were assessed during hospitalisation and until death or 30 days after admission.
  
  
  RESULTS
  We studied 117 patients, 69 (59%) were men. The mean age (standard deviation) was 84.7 (6.5) years. The 30-day mortality was 16.2%. The PSI score was 134.2 (31.8) on admission, and the BI scores on preadmission and admission were 60.3 (35.8) and 37.1 (33.5), respectively. In a multiple logistic regression model, using all variables statistically significant in the univariate analysis, those independently associated with 30-day mortality were: preadmission BI lower than 60 points (odds ratio = 4.89; 95% confidence interval, 1.27-18.9) and lymphopenia (odds ratio = 7.11; 95% confidence interval, 1.7-30.2).
  
  
  CONCLUSIONS
  In very old patients who were hospitalized for pneumonia, preadmission functional status was an independent predictor of mortality. Functional status should be included in the severity indices of pneumonia in this population.
authors.affiliation: Unidad Geriátrica de Agudos, Servicio de Medicina Interna, Hospital de Mataró, Mataró, Barcelona, España. mcabre@csdm.es
authors.forename: Mateu
authors.initials: M
authors.lastname: Cabré
authors.forename: Mateu
authors.initials: M
authors.lastname: Serra-Prat
authors.forename: Lluís
authors.initials: L
authors.lastname: Force
authors.forename: Elisabet
authors.initials: E
authors.lastname: Palomera
authors.forename: Roman
authors.initials: R
authors.lastname: Pallarés
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D018410:Pneumonia, Bacterial / Q000401:mortality*; D011446:Prospective Studies; D012307:Risk Factors