AI Article Synopsis
- An increasing number of elderly individuals in Japan face challenges with daily activities (ADLs), prompting a study to examine how ADLs relate to pneumonia-related clinical characteristics.
- The research involved 219 patients, classified by their ability to perform ADLs, which helped reveal that those with reduced functionality had higher disease severity and mortality rates.
- Results indicated that a lower ADL score significantly predicts higher 30-day mortality rates in patients with pneumonia, highlighting the importance of functional assessments in medical management.
Article Abstract
Objective: In Japan, the number of elderly people who have difficulties performing the activities of daily living (ADLs) is increasing. The objective of this study was to assess the relationship between ADL and the clinical characteristics of pneumonia.
Methods: We conducted a retrospective study of 219 adult patients hospitalized due to pneumonia [151 patients with community-acquired pneumonia (CAP) and 68 patients with healthcare-associated pneumonia (HCAP)]. CAP, HCAP, and all the patients were stratified into two groups using a modified version of the Katz index of five ADLs as follows: independent in all ADLs or dependent in one to three ADLs (CAP-A, HCAP-A, and All-A groups) and dependent in four or five ADLs (CAP-B, HCAP-B, and All-B groups). Disease severity, microbiological findings, and mortality were compared between the groups.
Results: As the ability to perform ADLs declined, A-DROP scores (the CAP severity measurement index) increased significantly in CAP (CAP-A: 1.1±1.1, CAP-B: 2.6±1.1), HCAP (HCAP-A: 2.0±1.0, HCAP-B: 2.8±1.0), and all patients (All-A: 1.3±1.1, All-B: 2.8±1.0). Thirty-day mortality was higher in the CAP-B (23.1%) and All-B (19.2%) groups than in the CAP-A (0.7%) and All-A (1.8%) groups, respectively. A multivariate Cox proportional hazards analysis showed an ADL score ≥ four to be a significant predictor of 30-day mortality in CAP patients [hazard ratio (HR), 19.057; 95% confidence interval (CI), 1.930-188.130] and in all patients (HR, 8.180; 95% CI, 1.998-33.494).
Conclusion: A functional assessment using a modified version of the Katz index is useful for the management of CAP and HCAP patients.
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| http://dx.doi.org/10.2169/internalmedicine.53.2499 | DOI Listing |
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