Independent Prognostic Indicators in the Elderly with Pneumonia: A Single-Center Prospective Observational Study

Abstract Background: The aim of this study was to investigate poor prognostic indicators in the elderly with pneumonia. Methods: In this prospective observational study, the patients with pneumonia were stratified into younger (18-64 years) and older (≥65 years) groups. The poor prognostic indicators were determined and compared. Results: There were 184 pneumonia episodes in 155 patients. The median age of the cases was 72 (range, 18-104) of whom 127 (69%) were ≥65 years old and 110 (59.8%) were male. Mental status changes were more common in the elderly group (p=0.04). Multivariate regression analysis determined three variables that could be potential independent risk factors for poor prognosis in the elderly: dyspnea at the onset (OR:5.85, CI:5.18-6.52, p=0.01), previous antibiotic use within the last 3 months (OR:2.97, CI:2.51-3.43, p=0.02), acute renal failure (OR:2.51, CI:2.06-2.96, p=0.04). A receiver operating characteristic (ROC) analysis showed that the area under the curves (AUC) of procalcitonin and C-reactive protein (CRP) as indicators of poor prognosis in the elderly were 0.846 (p<0.001) and 0.650 (p=0.008) respectively. In addition, mental status changes (p<0.001), the confusion, blood urea nitrogen, respiratory rate, blood pressure, and age ≥65 years (CURB-65) score (p<0.001), and the pneumonia severity index (PSI) (p<0.001) were associated with poor prognosis. Conclusion: Dyspnea at the onset, previous antibiotic use within the last 3 months, acute renal failure, serum CRP and procalcitonin levels along with the PSI and the CURB-65 scores should be carefully evaluated in terms of hospitalization, the need for intensive care unit admission and the initial antimicrobial therapy.

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Acute renal failure in critically ill newborns increases the risk of death: a prospective observational study from India

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.3109/14767058.2015.1107900 ◽

2015 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Ankur Patel ◽

Deepak Sharma ◽

Sweta Shastri ◽

Pradeep Sharma

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Observational Study ◽

Critically Ill ◽

Prospective Observational Study ◽

Risk Of Death

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Acute renal failure in the ICU setting: A prospective observational study

Medical Journal Armed Forces India ◽

10.1016/j.mjafi.2016.03.009 ◽

2016 ◽

Vol 72 (3) ◽

pp. 236-241 ◽

Cited By ~ 2

Author(s):

Shivinder Singh ◽

A.K. Patra ◽

Barun Patel ◽

G.S. Ramesh ◽

V.K. Sharma ◽

...

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Observational Study ◽

Prospective Observational Study

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INDEPENDENT PROGNOSTIC INDICATORS IN THE ELDERLY WITH PNEUMONIA: A SINGLECENTRE PROSPECTIVE OBSERVATIONAL STUDY

The Turkish Journal of Geriatrics ◽

10.31086/tjgeri.2020.171 ◽

2020 ◽

Vol 23 (3) ◽

pp. 342-352

Author(s):

Serkan SÜRME ◽

İlker İnanç BALKAN ◽

Osman Faruk BAYRAMLAR

Keyword(s):

Observational Study ◽

Prospective Observational Study ◽

The Elderly ◽

Prognostic Indicators

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ACUTE KIDNEY INJURY IN ELDERLY PATIENTS

Wiadomości Lekarskie ◽

10.36740/wlek201908109 ◽

2019 ◽

Vol 72 (8) ◽

pp. 1466-1472

Author(s):

Grażyna Kobus ◽

Jolanta Małyszko ◽

Hanna Bachórzewska-Gajewska

Keyword(s):

Acute Kidney Injury ◽

Renal Failure ◽

Acute Renal Failure ◽

Elderly Patients ◽

Older Patients ◽

Age Groups ◽

Kidney Injury ◽

The Elderly ◽

Younger Patients ◽

Common Cause

Introduction: In the elderly, impairment of kidney function occurs. Renal diseases overlap with anatomic and functional changes related to age-related involutionary processes. Mortality among patients with acute renal injury is approximately 50%, despite advances in treatment and diagnosis of AKI. The aim: To assess the incidence of acute kidney injury in elderly patients and to analyze the causes of acute renal failure depending on age. Materials and methods: A retrospective analysis included medical documentation of patients hospitalized in the Nephrology Clinic during the 6-month period. During this period 452 patients were hospitalized in the clinic. A group of 77 patients with acute renal failure as a reason for hospitalization was included in the study. Results: The prerenal form was the most common cause of AKI in both age groups. In both age groups, the most common cause was dehydration; in the group of patients up to 65 years of age, dehydration was 29.17%; in the group of people over 65 years - 43.39%. Renal replacement therapy in patients with AKI was used in 14.29% of patients. In the group of patients up to 65 years of age hemodialysis was 16.67% and above 65 years of age. -13.21% of patients. The average creatinine level in the group of younger patients at admission was 5.16 ± 3.71 mg / dl, in the group of older patients 3.14 ± 1.63 mg / dl. The size of glomerular filtration GFR in the group of younger patients at admission was 21.14 ± 19.54 ml / min, in the group of older patients 23.34 ± 13.33 ml / min. Conclusions: The main cause of acute kidney injury regardless of the age group was dehydration. Due to the high percentage of AKI in the elderly, this group requires more preventive action, not only in the hospital but also at home.

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Safety of High-Dose Dabigatran in Elderly and Younger Patients with a Low Bleeding Risk: A Prospective Observational Study

Cardiology ◽

10.1159/000516368 ◽

2021 ◽

pp. 1-5

Author(s):

Aharon Erez ◽

Gregory Golovchiner ◽

Robert Klempfner ◽

Ehud Kadmon ◽

Gustavo Ruben Goldenberg ◽

...

Keyword(s):

Observational Study ◽

Elderly Patients ◽

Prospective Observational Study ◽

Bleeding Risk ◽

The Elderly ◽

High Dose ◽

World Population ◽

Younger Patients ◽

End Point

Introduction: In patients with atrial fibrillation (AF) at risk for stroke, dabigatran 150 mg twice a day (DE150) is superior to warfarin for stroke prevention. However, there is paucity of data with respect to bleeding risk at this dose in elderly patients (≥75 years). We aimed to evaluate the safety of DE150 in comparison to warfarin in a real-world population with AF and low bleeding risk (HAS-BLED score ≤2). Methods: In this prospective observational study, 754 consecutive patients with AF and HAS-BLED score ≤2 were included. We compared outcome of elderly patients (age ≥75 tears) to younger patients (age <75 years). The primary end point was the combined incidence of all-cause mortality, stroke, systemic emboli, and major bleeding event during a mean follow-up of 1 year. Results: There were 230 (30%) elderly patients, 151 patients were treated with warfarin, and 79 were treated with DE150. Fifty-two patients experienced the primary endpoint during the 1-year follow-up. Among the elderly, at 1-year of follow-up, the cumulative event rate of the combined endpoint in the DE150 and warfarin was 8.9 and 15.9% respectively (p = 0.14). After adjustment for age and gender, patients who were treated with DE150 had a nonsignificant difference in the risk for the combined end point as patients treated with warfarin both among the elderly and among the younger population (HR 0.58, 95% C.I = 0.25–1.39 and HR = 1.12, 95% C.I 0.62–2.00, respectively [p for age-group-by-treatment interaction = 0.83). Conclusions: Our results suggest that Dabigatran 150 mg twice a day can be safely used among elderly AF patients with low bleeding risk.

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