Predicting 1-year mortality after hospitalization for community-acquired pneumonia

<div><p>Background</p><p>Community-acquired pneumonia (CAP) is a major public health problem with high short- and long-term mortality. The main aim of this study was to develop and validate a specific prognostic index for one-year mortality in patients admitted for CAP.</p><p>Methods</p><p>This was an observational, prospective study of adults aged ≥18 years admitted to Galdakao-Usansolo Hospital (Bizkaia, Spain) from January 2001 to July 2009 with a diagnosis of CAP surviving the first 15 days. The entire cohort was divided into two parts, in order to develop a one-year mortality predictive model in the derivation cohort, before validation using the second cohort.</p><p>Results</p><p>A total of 2351 patients were included and divided into a derivation and a validation cohort. After deaths within 15 days were excluded, one-year mortality was 10.63%. A predictive model was created in order to predict one-year mortality, with a weighted score that included: aged over 80 years (4 points), congestive heart failure (2 points), dementia (6 points), respiratory rate ≥30 breaths per minute (2 points) and blood urea nitrogen >30 mg/dL (3 points) as predictors of higher risk with C-index of 0.76. This new model showed better predictive ability than current risk scores, PSI, CURB65 and SCAP with C-index of 0.73, 0.69 and 0.70, respectively.</p><p>Conclusions</p><p>An easy-to-use score, called the one-year CAPSI, may be useful for identifying patients with a high probability of dying after an episode of CAP.</p></div

Multivariate survival analysis for one-year mortality in the derivation and validation cohorts by risk stratification groups.

<p>Multivariate survival analysis for one-year mortality in the derivation and validation cohorts by risk stratification groups.</p

Predictive accuracy and goodness of fit for one-year mortality of continuous risk scores.

<p>Predictive accuracy and goodness of fit for one-year mortality of continuous risk scores.</p

Kaplan-Meier survival curve for the derivation and validation cohorts, stratified by one-year CAPSI risk groups.

<p>Kaplan-Meier survival curve for the derivation and validation cohorts, stratified by one-year CAPSI risk groups.</p

Risk-score distribution diagram according to the one-year CAPSI score risk groups.

<p>Minor risk factors: Chronic Heart Failure (CHF), Respiratory Rate (RR), Blood Urea Nitrogen (BUN). 2 minor risk factors: any pairwise combination of the minor risk factors. 3 minor risk factors: number of patients with the three minor risk factors. Age + any minor risk factor: age in combination with one, two or three minor factors. Dementia + any other risk factor: Dementia combined with other risk factor (age, one, two or three minor risk factors). D: number of deaths / number of patients at risk in the <u>derivation sample</u>. V: number of deaths / number of patients at risk in the <u>validation sample</u>.</p

Multivariate survival analysis for one-year mortality in the derivation and validation cohorts, i.e. one-year CAPSI.

<p>Multivariate survival analysis for one-year mortality in the derivation and validation cohorts, i.e. one-year CAPSI.</p

Additional file 2 of Long-term health related quality of life in total knee arthroplasty

Supplementary Material

Additional file 3 of Long-term health related quality of life in total knee arthroplasty

Supplementary Material

Additional file 1 of Long-term health related quality of life in total knee arthroplasty

Supplementary Material