Impact of the age-adjusted Charlson comorbidity index on in-hospital mortality in long-living people with community-acquired pneumonia and a predictive mortality model
Objective To investigate the relationship between the age-adjusted Charlson comorbidity index(aCCI)and the risk of in-hospital death for people aged≥90 years with community-acquired pneumonia(CAP),and to construct a novel scoring model for predicting in-hospital mortality.Methods Basic personal and medical data about sex,age,hospitalization days,hospitalization expenses,in-hospital outcomes and discharge/admitting diagnosis of CAP patients aged≥90 years hospitalized in Peking University Third Hospital between 2010 and 2019 were collected retrospectively.Multivariate Logistic regression analysis was conducted to examine the association between aCCI or other complications and in-hospital death.The receiver operating characteristic curve(ROC)was used to assess the value of aCCI and a new scoring model in predicting in-hospital death of CAP in people aged≥90 years.Results A total of 274 CAP patients aged≥90 years were included in this study,of whom 85 died in hospital.Multivariate Logistic regression analysis showed that malnutrition(OR=2.21,95％CI:1.05-4.67,P＜0.05),respiratory failure(OR=18.91,95％CI:9.34-38.25,P＜0.001)and aCCI(OR=1.51,95％CI:1.23-1.85,P＜0.001)were prognostic factors for in-hospital death in CAP patients aged≥90 years.Based on the above results,a novel scoring model,MRC(malnutrition,respiratory failure,aCCI)was established.The area under the ROC curve of the aCCI score for predicting the risk of in-hospital death in CAP patients aged≥90 years was 0.743(95％CI:0.684-0.802).The area under the ROC curve of the MRC score was 0.891(95％CI:0.848-0.933),indicating a higher predictive value than that of the aCCI score alone(Z=6.337,P＜0.001).Conclusions The MRC score model can be used to evaluate and predict the risk of in-hospital death in long-living CAP patients.
NETL
NSTL
万方数据
维普
