title: Geriatric assessment and prognostic factors of mortality in very elderly patients with community-acquired pneumonia.
abstract: BACKGROUND
  To assess the relationship between the parameters obtained in the geriatric assessment and mortality in elderly people with community-acquired pneumonia in an acute care geriatric unit.
  
  
  METHODS
  Four hundred fifty-six patients (≥75years).
  
  
  METHODS
  age, sex, referral source, background, consciousness level, heart rate, breathing rate, blood pressure, laboratory data, pleural effusion, multilobar infiltrates, functional status (activities of daily living) prior to admission [Lawton index (LI), Barthel index (BIp)] prior to and at admission (BIa), cognitive status [Pfeiffer test (PT)], comorbidity [Charlson index (ChI)] and nutrition (total protein, albumin).
  
  
  RESULTS
  A hundred ten patients died (24.2%) during hospitalization. These patients were older (86.6±6.4 vs 85.1±6.4, P<.04), had more comorbidity (ChI 2.35±1.61 vs 2.08±1.38; P<.083), worse functional impairment [(LI: 0.49±1.15 vs 1.45±2.32, P<.001) (BIp: 34.6±32.9 vs 54.0±34.1, P<.001) (BIa: 5.79±12.5 vs 20.5±22.9, P<.001)], a higher percentage of functional loss at admission (85.9±23.2 vs 66.4±28.6; P<.0001), worse cognitive impairment (PT: 7.20±3.73 vs 5.10±3.69, P<.001) and malnutrition (albumin 2.67±0.54 vs 2.99±0.49, P<.001). Mortality was higher with impaired consciousness [49.2% (P<.01)], tachypnea [33.3% (P<.01)], tachycardia [44.4% (P<.002), high urea levels [31.8 (P<.001)], anemia [44.7% (P<.02)], pleural effusion [42.9% (P<.002)], and multilobar infiltrates [43.2% (P<.001)]. In the multivariate analysis, variables associated with mortality were: age ≥90years [OR: 3.11 (95%CI: 1.31 to 7.36)], impaired consciousness [3.19 (1.66 to 6.15)], hematocrit <30% [2.87 (1.19 to 6.94)], pleural effusion [3.77 (1.69 to 8.39)] and multilobar infiltrates [2.76 (1.48 to 5.16)]. Female sex and a preserved functional status prior (LI≥5) and during admission (BIa≥40) were protective of mortality [0.40 (0.22 to 0.70), 0.09 (0.01 to 0.81) and 0.11 (0.02 to 0.51)].
  
  
  CONCLUSIONS
  Geriatric assessment parameters and routine clinical variables were associated with mortality.
authors.affiliation: Parc Sanitari Pere Virgili, Barcelona, España. Electronic address: acalle@perevirgili.catsalut.net.
authors.forename: Alicia
authors.initials: A
authors.lastname: Calle
authors.affiliation: Servicio de Geriatría, Parc de Salut Mar, Hospital del Mar-Hospital de la Esperanza-Centro Forum, Barcelona, España.
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Márquez
authors.affiliation: Servicio de Geriatría, Parc de Salut Mar, Hospital del Mar-Hospital de la Esperanza-Centro Forum, Barcelona, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Arellano
authors.affiliation: Parc Sanitari Pere Virgili, Barcelona, España.
authors.forename: Laura Mónica
authors.initials: LM
authors.lastname: Pérez
authors.affiliation: Servicio de Geriatría, Parc de Salut Mar, Hospital del Mar-Hospital de la Esperanza-Centro Forum, Barcelona, España.
authors.forename: Maria
authors.initials: M
authors.lastname: Pi-Figueras
authors.affiliation: Servicio de Geriatría, Parc de Salut Mar, Hospital del Mar-Hospital de la Esperanza-Centro Forum, Barcelona, España.
authors.forename: Ramón
authors.initials: R
authors.lastname: Miralles
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000401:mortality; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies
keywords: Anciano; Capacidad funcional; Elderly; Functional status; Geriatric assessment; Mortalidad; Mortality; Neumonía; Pneumonia; Valoración geriátrica