Education＆ScienceEducational Article
Development of a score model to predict long-term prognosis after community-onset pneumonia in older patients
August 2024
Authors: Takahiro Takazono, Hotaka Namie, Yohsuke Nagayoshi, Yoshifumi Imamura, Yuya Ito, Makoto Sumiyoshi, Nobuyuki Ashizawa, Masataka Yoshida, Kazuaki Takeda, Naoki Iwanaga, Shotaro Ide, Yosuke Harada, Naoki Hosogaya, Shinnosuke Takemoto, Yuichi Fukuda, Kazuko Yamamoto, Taiga Miyazaki, Noriho Sakamoto, Yasushi Obase, Toyomitsu Sawai, Yasuhito Higashiyama, Kohji Hashiguchi, Satoshi Funakoshi, Naofumi Suyama, Hikaru Tanaka, Katsunori Yanagihara, Koichi Izumikawa, Hiroshi Mukae
Comment by Mark Lavercombe: Prediction of short- to medium-term mortality in patients with community-acquired pneumonia (CAP) is an important element of guideline-based practice in many institutions. In this article from Japan, the authors sought to identify older patients with CAP and a higher risk of mortality at six months, in order to prioritise symptom driven care rather than aggressive pneumonia-specific management. In a cohort of 322 patients with a mean age of 82 and after multiple logistic regression analysis, poor prognostic factors including lower performance score, low albumin and dementia. A simple prediction model for mortality at 180 days tested on their remaining 77 cases demonstrated an area under the receiver operating characteristic curve of 0.7925, with high sensitivity (91.7%) and negative predictive value (97.6%).