• Hon Ming Ma, Wing Han Tang, and Jean Woo.
• Department of Medicine and Therapeutics, Prince of Wales Hospital, the Chinese University of Hong Kong, China. hmma@cuhk.edu.hk
• Age Ageing. 2011 Nov 1;40(6):736-41.

Backgroundthere were a few studies on the case mortality of pneumonia in older people, of which results were conflicting.Objectivesthis study aimed to identify risk factors associated with in-hospital mortality in older patients admitted for community-acquired pneumonia (CAP).Designa prospective cohort study.Settinghospital sample.Subjectsduring the 1-year study period (from October 2009 to September 2010), 488 older patients aged 65 or above were recruited.Methodsdemographic characteristics, medical illnesses (Charlson's comorbidity index (CCI)), premorbid functional status (Katz's index) and baseline blood tests were recorded. The outcome was in-hospital mortality.Resultsin this cohort of patients, the mean age was 81.0 years (±7.9) and 282 (57.8%) were male. Nursing home residents accounted for 23.8% (116/488) of study subjects. The median CCI was 2 (inter-quartile range (IQR): 1-3); 60 (12.3%) patients succumbed during hospital stay. Logistic regression showed that comorbidities, mid-arm circumference, serum albumin level and severity of pneumonia (Confusion, blood Urea nitrogen, Respiratory rate and low Blood pressure (CURB) score) were independent predictors of in-hospital mortality of pneumonia.Conclusionin keeping with previous studies, CURB score and comorbidities were the most significant independent predictors of mortality of CAP in older patients. Our study concluded that nutritional status was also an important factor affecting their survival. This study failed to demonstrate functional status as a predictor of mortality due to limitation of Katz's index.

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