Recurrent hospitalisation with pneumonia is associated with higher 1-year mortality in frail older people

摘要: Background: Previous studies persistently showed that functional dependence was associated with higher long-term (≥1 year) mortality of older patients hospitalised community-acquired pneumonia (CAP). The importance other factors was, however, not well reported. Aim: This study aimed to investigate the relative contributions comorbidity, nutritional status and frailty 1-year mortality. Methods: We prospectively recruited patients, aged ≥65 years, CAP from October 2009 September 2010 at Prince Wales Hospital, Hong Kong. Demographics, Charlson’s Comorbidity Index, mid-arm circumference (MAC) Clinical Frailty Scale (CFS) were recorded as baseline characteristics. severity evaluated by CURB score (confusion, blood urea nitrogen, respiratory rate low pressure). surviving followed for 1 year since discharge monitor readmission all-cause entered following variables into multivariate Cox regression model identify independent predictors mortality: age, sex, residential status, MAC, CFS CAP. Results: final cohort consisted 428 who discharged hospital. Within after hospital discharge, 22.4% 32.0% respectively. Independent male sex (hazard ratio (HR) = 1.57, 95% confidence interval (CI) 1.02–2.48), severe under-nutrition (MAC ≤21 cm) (HR 3.75, CI 1.66–8.46), (CFS ≥5) 2.36, 1.29–4.27) 4.50, 2.82–7.17). Conclusions: Recurrent may be a terminal life event frail people so advance care planning should considered in those recurrent admission pneumonia.