Performance status and in-hospital mortality of elderly patients with community acquired pneumonia |
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Authors: | Filippo Pieralli Vieri Vannucchi Giulia De Marzi Antonio Mancini Francesca Bacci Ombretta Para Carlo Nozzoli Marco Falcone |
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Affiliation: | 1.Subintensiva di Medicina, Internal and Emergency Medicine Department,Azienda Ospedaliero-Universitaria Careggi,Florence,Italy;2.Internal Medicine,Santa Maria Nuova Hospital, USL Toscana Centro,Florence,Italy;3.Department of Public Health and Infectious Diseases,“Sapienza” University of Rome,Rome,Italy |
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Abstract: | To evaluate the role of performance status evaluated by the Eastern Cooperative Oncology Group (ECOG) score in predicting 30-day mortality in subjects hospitalized for community acquired pneumonia (CAP), this was a prospective study of patients consecutively hospitalized for CAP at a large University Hospital in Italy. Performance status was evaluated using the ECOG score that in a 0–5 point scale indicates progressive functional deterioration. The end-point of the study is the 30-day mortality. Two-hundred-sixteen patients were enrolled, 75.9% were aged?>?70 years, 31.5% had severe pneumonia at CURB-65 score (3–4), and 27.5% of patients had severe disability (ECOG 3–4). Thirty-day mortality is 15.3%. Progression in ECOG score independently increases the probability of 30-day mortality at multivariable logistic regression analysis (HR 2.19, 95% CI 1.60–3.01, p?0.0001). ECOG 3 or 4 determines a four-fold increase in 30-day mortality (HR 4.07, 95% CI 1.84–9.02, p?0.001). ECOG score 3 or 4 is highly predictive of death in patients classified at low risk of mortality by CURB-65 (0–2 points) score. Functional status is directly related to outcome in elderly patients hospitalized for CAP. The use of a very simple and fast tool, such as the ECOG score, might help to better stratify the risk of short-term mortality, especially in patients otherwise classified at low risk of death by CURB-65 score. |
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