Differential roles of comorbidity burden and functional status in elderly and non-elderly patients with infections in general wards
Journal
Journal of the Formosan Medical Association
Journal Volume
119
Journal Issue
4
Pages
821-828
Date Issued
2020
Author(s)
Abstract
Background: Differential roles of comorbidity burden, functional status and severity of illness in elderly and non-elderly patients admitted to general wards with infections in terms of short-term and long-term mortality remain poorly understood and worth further investigation. Methods: From 2011 to 2013, patients admitted to general wards with a main diagnosis of infections were included and their Barthel index, Charlson comorbidity index and Pitt bacteremia score were collected to evaluate their association with in-hospital and 1-year outcomes of the study cohort. Age stratification was applied for all outcome analysis. Results: A total of 2481 patients were identified, with main diagnoses of pneumonia (57%), urinary tract infection (28%) and intra-abdominal infection (18%). In-hospital mortality occurred in 291 (12%) of the population and was independently predicted by Barthel index ?50 (odds ratio [OR] 5.67 and 2.73, respectively) and Charlson comorbidity index >2 (OR 1.49 and 2.87, respectively) in both elderly and non-elderly patients. Among 2190 hospital survivors, Barthel index ?50 (hazard ratio [HR] 1.38) and Charlson comorbidity index >2 (HR 1.96) were associated with a higher hazard of 1-year mortality in elderly patients. However, only Charlson comorbidity index >2 (HR 2.87) was a significant characteristic of non-elderly patients to be correlated with higher 1-year mortality. Conclusion: This study found that functional status on admission was predictive of in-hospital mortality of general patients with infections irrespective of age groups; however, it played a differential role in 1-year mortality in between elderly and non-elderly patients, emphasizing the importance of functional assessment among the elderly. ? 2019
SDGs
Other Subjects
abdominal infection; aged; Article; bacteremia; Barthel index; central nervous system infection; cerebrovascular accident; Charlson Comorbidity Index; chronic kidney failure; chronic obstructive lung disease; cohort analysis; comorbidity; coronary artery disease; diabetes mellitus; disease severity; female; functional status; general hospital; heart failure; hospital admission; hospital mortality; hospital patient; human; infection; liver cirrhosis; major clinical study; male; outcome assessment; Pitt bacteremia score; pneumonia; retrospective study; skin infection; soft tissue infection; urinary tract infection; ward; abdominal infection; comorbidity; geriatric assessment; health care facility; hospital mortality; hospitalization; middle aged; pneumonia; proportional hazards model; severity of illness index; Taiwan; urinary tract infection; very elderly; Aged; Aged, 80 and over; Comorbidity; Female; Functional Status; Geriatric Assessment; Hospital Mortality; Hospitalization; Humans; Intraabdominal Infections; Male; Middle Aged; Patients' Rooms; Pneumonia; Proportional Hazards Models; Retrospective Studies; Severity of Illness Index; Taiwan; Urinary Tract Infections
Publisher
Elsevier B.V.
Type
journal article