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Research article
Disease burden and prognostic factors for clinical failure in elderly community acquired pneumonia patients
Bin Cao
Chiana-Japan Friendship Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7572-3321
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Infectious Diseases.
Background: The study was to evaluate initial antimicrobial regimen and clinical outcomes and to explore risk factors for clinical failure (CF) in elderly patients with community-acquired pneumonia (CAP).
Methods: 3,011 hospitalized elderly patients were enrolled from 13 national teaching hospitals between January 1, 2014 and December 31, 2014 initiated by the CAP-China network. Risk factors for CF were screened by multivariable logistic regression analysis.
Results: The incidence of CF in elderly CAP patients was 13.1%. CF patients were older, longer hospital stays and higher treatment costs than clinical success (CS) patients. The CF patients were more prone to present hyperglycemia, hyponatremia, hypoproteinemia, pleural effusion, respiratory failure and cardiovascular events. Inappropriate initial antimicrobial regimens in CF group were significantly higher than CS group. Undertreatment, CURB-65, PH<7.3, PaO2/FiO2 < 200 mmHg, sodium <130 mmol/L, healthcare-associated pneumonia, white blood cells >10000/mm3, pleural effusion and congestive heart failure were independent risk factors for CF in multivariable logistic regression analysis. Male and bronchiectasis were protective factors.
Conclusions: Discordant therapy was a cause of CF. Early accurate detection and management of prevention to potential causes is likely to improve clinical outcomes in elderly patients CAP.
Trial registration: A Retrospective Study on Hospitalized Patients With Community-acquired Pneumonia in China (CAP-China) (RSCAP-China), NCT02489578. Registered 16 March 2015, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0005E5S&selectaction=Edit&uid=U0000GWC&ts=2&cx=1bnotb
Keywords
community-acquired pneumonia; clinical failure; treatment pattern; elderly
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CURRENT STATUS: Published
Version 2
Posted 18 Jun, 2020
Published
On 12 Sep, 2020
No community comments so far
Editorial decision: Accept
On 19 Aug, 2020
Review #1 received
Received 25 Jul, 2020
Reviewers invited
Invitations sent on 07 Jul, 2020
Reviewer #1 agreed
On 07 Jul, 2020
Editor assigned
On 17 Jun, 2020
Submission checks complete
On 16 Jun, 2020
Editor invited
On 16 Jun, 2020
No comments provided
Editorial decision: Major revision
On 10 Jun, 2020
Review #2 received
Received 03 Jun, 2020
Reviewer #2 agreed
On 15 May, 2020
Review #1 received
Received 13 May, 2020
Reviewers invited
Invitations sent on 21 Apr, 2020
Reviewer #1 agreed
On 21 Apr, 2020
Editor assigned
On 17 Apr, 2020
Submission checks complete
On 08 Apr, 2020
Editor invited
On 08 Apr, 2020
First submitted
On 04 Apr, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
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This preprint is under consideration at BMC Infectious Diseases. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Disease burden and prognostic factors for clinical failure in elderly community acquired pneumonia patients
Bin Cao
Chiana-Japan Friendship Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7572-3321
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 18 Jun, 2020
Published
On 12 Sep, 2020
No community comments so far
Editorial decision: Accept
On 19 Aug, 2020
Review #1 received
Received 25 Jul, 2020
Reviewers invited
Invitations sent on 07 Jul, 2020
Reviewer #1 agreed
On 07 Jul, 2020
Editor assigned
On 17 Jun, 2020
Submission checks complete
On 16 Jun, 2020
Editor invited
On 16 Jun, 2020
No comments provided
Editorial decision: Major revision
On 10 Jun, 2020
Review #2 received
Received 03 Jun, 2020
Reviewer #2 agreed
On 15 May, 2020
Review #1 received
Received 13 May, 2020
Reviewers invited
Invitations sent on 21 Apr, 2020
Reviewer #1 agreed
On 21 Apr, 2020
Editor assigned
On 17 Apr, 2020
Submission checks complete
On 08 Apr, 2020
Editor invited
On 08 Apr, 2020
First submitted
On 04 Apr, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Infectious Diseases.
Background: The study was to evaluate initial antimicrobial regimen and clinical outcomes and to explore risk factors for clinical failure (CF) in elderly patients with community-acquired pneumonia (CAP).
Methods: 3,011 hospitalized elderly patients were enrolled from 13 national teaching hospitals between January 1, 2014 and December 31, 2014 initiated by the CAP-China network. Risk factors for CF were screened by multivariable logistic regression analysis.
Results: The incidence of CF in elderly CAP patients was 13.1%. CF patients were older, longer hospital stays and higher treatment costs than clinical success (CS) patients. The CF patients were more prone to present hyperglycemia, hyponatremia, hypoproteinemia, pleural effusion, respiratory failure and cardiovascular events. Inappropriate initial antimicrobial regimens in CF group were significantly higher than CS group. Undertreatment, CURB-65, PH<7.3, PaO2/FiO2 < 200 mmHg, sodium <130 mmol/L, healthcare-associated pneumonia, white blood cells >10000/mm3, pleural effusion and congestive heart failure were independent risk factors for CF in multivariable logistic regression analysis. Male and bronchiectasis were protective factors.
Conclusions: Discordant therapy was a cause of CF. Early accurate detection and management of prevention to potential causes is likely to improve clinical outcomes in elderly patients CAP.
Trial registration: A Retrospective Study on Hospitalized Patients With Community-acquired Pneumonia in China (CAP-China) (RSCAP-China), NCT02489578. Registered 16 March 2015, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0005E5S&selectaction=Edit&uid=U0000GWC&ts=2&cx=1bnotb
Figure 1