ABSTRACT
Background: The Charlson Comorbidity Index (CCI) is the most widely used method to measure comorbidity and predict mortality. There is no evidence whether malnutrition and/or poor physical function are associated with higher CCI in hospitalized patients. Therefore, this study aimed to (i) analyze the association between the CCI with nutritional status and with physical function of hospitalized older adults and (ii) examine the individual and combined associations of nutritional status and physical function of older inpatients with comorbidity risk. Methods: A total of 597 hospitalized older adults (84.3 ± 6.8 years, 50.3% women) were assessed for CCI, nutritional status (the Mini Nutritional Assessment-Short Form [MNA-SF]), and physical function (handgrip strength and the Short Physical Performance Battery [SPPB]). Results: Better nutritional status (p < 0.05) and performance with handgrip strength and the SPPB were significantly associated with lower CCI scores among both men (p < 0.005) and women (p < 0.001). Patients with malnutrition or risk of malnutrition (OR: 2.165, 95% CI: 1.408-3.331, p < 0.001) as well as frailty (OR: 3.918, 95% CI: 2.326-6.600, p < 0.001) had significantly increased the risk for being at severe risk of comorbidity. Patients at risk of malnutrition or that are malnourished had higher CCI scores regardless of being fit or unfit according to handgrip strength (p for trend < 0.05), and patients classified as frail had higher CCI despite their nutritional status (p for trend < 0.001). Conclusions: The current study reinforces the use of the MNA-SF and the SPPB in geriatric hospital patients as they might help to predict poor clinical outcomes and thus indirectly predict post-discharge mortality risk.
ABSTRACT
INTRODUCCIÓN: La infección osteoarticular neumocócica es una complicación poco frecuente de la bacteriemia neumocócica, debido a los avances en la terapia antibiótica y en el patrón de inmunización. MÉTODOS: Estudio retrospectivo de los pacientes con infección osteoarticular por neumococo entre enero de 2003 y diciembre de 2013 en un hospital tercer nivel. RESULTADOS: Cinco de los 321 pacientes con bacteriemia neumocócica presentaron infección osteoarticular. Todos padecían al menos una enfermedad crónica de base y habían sido inmunizados de acuerdo con el calendario vacunal habitual. La cadera y las vértebras fueron las más frecuentemente afectadas. La evolución fue favorable en todos los casos. CONCLUSIONES: Es necesario tener en cuenta las características clínicas de la infección osteoarticular neumocócica. Su prevención óptima en los pacientes de alto riesgo debe incluir la vacuna conjugada 13V
INTRODUCTION: Osteoarticular pneumococcal infection is an infrequent complication of pneumococcal bacteremia, due to the advances in antibiotic therapy and in the pattern of immunization. METHODS: A retrospective study was conducted on patients diagnosed with osteoarticular pneumococcal infection between January 2003 and December 2013 in the University Hospital Marqués de Valdecilla in Santander. RESULTS: Five out of 321 patients diagnosed with pneumococcal bacteremia had osteoarticular infection. All of them had at least one chronic underlying disease and had been immunized according to the standard vaccination schedule. Hip and vertebra were the most common joints involved. Outcome was favorable in all cases. CONCLUSIONS: The clinical findings of pneumococcal osteoarticular infection should be borne in mind. Its optimal prevention in high-risk patients should include the 13V conjugate vaccine
Subject(s)
Humans , Joint Diseases/microbiology , Bone Diseases, Infectious/microbiology , Streptococcus pneumoniae/pathogenicity , Retrospective Studies , Bacteremia/complications , Pneumococcal Vaccines/administration & dosage , Risk FactorsABSTRACT
INTRODUCTION: Osteoarticular pneumococcal infection is an infrequent complication of pneumococcal bacteremia, due to the advances in antibiotic therapy and in the pattern of immunization. METHODS: A retrospective study was conducted on patients diagnosed with osteoarticular pneumococcal infection between January 2003 and December 2013 in the University Hospital Marqués de Valdecilla in Santander. RESULTS: Five out of 321 patients diagnosed with pneumococcal bacteremia had osteoarticular infection. All of them had at least one chronic underlying disease and had been immunized according to the standard vaccination schedule. Hip and vertebra were the most common joints involved. Outcome was favorable in all cases. CONCLUSIONS: The clinical findings of pneumococcal osteoarticular infection should be borne in mind. Its optimal prevention in high-risk patients should include the 13V conjugate vaccine.
