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Predicting the Readmission and Mortality in Older Patients Hospitalized with Pneumonia with Preadmission Frailty

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  • Clinics and Public Health
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Abstract

Background

In older people, frailty has been recognized as an important prognostic factor. However, only a few studies have focused on multidimensional frailty as a predictor of mortality and readmission among inpatients with pneumonia.

Objective

The present study aimed to assess the association between preadmission frailty and clinical outcomes after the hospitalization of older patients with pneumonia.

Design

Single-center, retrospective case-control study.

Setting

Acute phase hospital at Kobe, Japan.

Participants

The present study included 654 consecutive older inpatients with pneumonia.

Measurements

Frailty status before admission was assessed using total Kihon Checklist (KCL) score, which has been used as a self-administered questionnaire to assess comprehensive frailty, including physical, social, and cognitive status. The primary outcome was a composited 6-month mortality and readmission after discharge.

Results

In total, 330 patients were analyzed (median age; 79 years, male; 70.4%, median total KCL score; 10 points), of which 68 were readmitted and 10 died within 6 months. After multivariate analysis, total KCL score was associated with a composited 6-month mortality and readmission (adjusted hazard ratio, 1.07; 95% confidence interval, 1.02–1.12; p = 0.006). The cutoff value for total KCL score determined by receiver operating characteristic curve analysis was 15 points (area under the curve = 0.610). The group with a total KCL score ≥ 15 points had significantly higher readmission or mortality rates than the groups with a total KCL score < 15 points (p < 0.001).

Conclusions

Preadmission frailty status in older patients with pneumonia was an independent risk factor for readmission and survival after hospitalization.

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Acknowledgments

We are indebted to the large number of patients who agreed participate and cooperate in this study. We thank all of the staff and participants at the Kobe City Medical Center General Hospital for their support in the present study. We would like to thank Editage (https://www.editage.com) for English language editing.

Funding

Funding: The authors declare no funding.

Author information

Authors and Affiliations

  1. Department of Rehabilitation, Kobe City Medical Center General Hospital, 2-1-1, Minatojimaminami, Chuo, Kobe, Hyogo, 650-0047, Japan

    K. Yamada, Kentaro Iwata, A. Honda, T. Kitai & N. Kohara

  2. Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan

    K. Yamada, Kentaro Iwata, Y. Oki, Y. Mitani, Y. Oki, Y. Yamada, K. Ono & A. Ishikawa

  3. Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan

    Y. Yoshimura

  4. Department of Rehabilitation, Shinshu University Hospital, Nagano, Japan

    H. Ota

  5. Faculty of Nursing, Osaka Medical College, Osaka, Japan

    A. Yamamoto

  6. Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan

    R. Tachikawa & K. Tomii

Authors
  1. K. Yamada
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  2. Kentaro Iwata
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  3. Y. Yoshimura
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  4. H. Ota
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  5. Y. Oki
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  6. Y. Mitani
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  7. Y. Oki
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  10. K. Ono
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Contributions

Authorship statement: KY prepared the manuscript and reviewed the literature. KY, KI, YO (Yutaro Oki), YM, YO (Yukari Oki), YY, AY, AH, and AI conceived and designed the study. KY and HO collected the data. KY analyzed the data. KY, YY (Yoshihiro Yoshimura), YO (Yutaro Oki), YM, YO (Yukari Oki), YY (Yoji Yamada), AY, RT, KT, NK, and AI drafted or critically revised the manuscript for important intellectual content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kentaro Iwata.

Ethics declarations

Ethical approval: The present study was approved by the ethics committee of Kobe City Medical Center General Hospital (approval no. ZN200714).

Informed consents: Not applicable.

Additional information

Conflicts of interest: The authors declare no conflict of interest.

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Yamada, K., Iwata, K., Yoshimura, Y. et al. Predicting the Readmission and Mortality in Older Patients Hospitalized with Pneumonia with Preadmission Frailty. J Frailty Aging 12, 208–213 (2023). https://doi.org/10.14283/jfa.2022.36

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  • DOI: https://doi.org/10.14283/jfa.2022.36

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