Prognostic factors for mortality due to pneumonia among adults from different age groups in Singapore and mortality predictions based on PSI and CURB-65
Singapore medical journal
; : 190-198, 2018.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-687881
Responsible library:
WPRO
ABSTRACT
<p><b>INTRODUCTION</b>Pneumonia is associated with considerable mortality. However, there is limited information on age-specific prognostic factors for death from pneumonia.</p><p><b>METHODS</b>Patients hospitalised with a diagnosis of pneumonia through the emergency department were stratified into three age groups 18-64 years, 65-84 years and ≥ 85 years. Multivariate logistic regression and receiver operating characteristic curve analyses were conducted to evaluate prognostic factors for mortality and the performance of pneumonia severity scoring tools for mortality prediction.</p><p><b>RESULTS</b>A total of 1,902 patients were enrolled (18-64 years 614 [32.3%]; 65-84 years 944 [49.6%]; ≥ 85 years 344 [18.1%]). Mortality rates increased with age (18-64 years 7.3%; 65-84 years 16.1%; ≥ 85 years 29.7%; p < 0.001). Malignancy and tachycardia were prognostic of mortality among patients aged 18-64 years. Male gender, malignancy, congestive heart failure and eight other parameters reflecting acute disease severity were associated with mortality among patients aged 65-84 years. For patients aged ≥ 85 years, altered mental status, tachycardia, blood urea nitrogen, hypoxaemia, arterial pH and pleural effusion were significantly predictive of mortality. The Pneumonia Severity Index (PSI) was more sensitive than CURB-65 (confusion, uraemia, respiratory rate ≥ 30 per minute, low blood pressure, age ≥ 65 years) for mortality prediction across all age groups.</p><p><b>CONCLUSION</b>The predictive effect of prognostic factors for mortality varied among patients with pneumonia from the different age groups. PSI performed significantly better than CURB-65 for mortality prediction, but its discriminative power decreased with advancing age.</p>
Full text:
Available
Health context:
SDG3 - Target 3.3 End transmission of communicable diseases
/
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Pneumonia
/
Other Respiratory Diseases
Database:
WPRIM (Western Pacific)
Main subject:
Patient Admission
/
Pneumonia
/
Prognosis
/
Singapore
/
Severity of Illness Index
/
Algorithms
/
Epidemiology
/
Multivariate Analysis
/
Predictive Value of Tests
/
Risk Factors
Type of study:
Diagnostic study
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Etiology study
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Prognostic study
/
Risk factors
Limits:
Adolescent
/
Adult
/
Aged
/
Aged, 80 and over
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
English
Journal:
Singapore medical journal
Year:
2018
Document type:
Article