Format

Send to

Choose Destination
See comment in PubMed Commons below
J Am Geriatr Soc. 2006 Jul;54(7):1062-7.

Assessment of pneumonia in older adults: effect of functional status.

Author information

1
Division of Geriatric Medicine, Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan 48105, USA. lonamody@umich.edu

Abstract

OBJECTIVES:

Evaluate the effect of preadmission functional status on severity of pneumonia, length of hospital stay (LOS), and all-cause 30-day and 1-year mortality of adults aged 60 and older and to understand the effect of pneumonia on short-term functional impairment.

DESIGN:

Prospective cohort study.

SETTING:

University hospital.

PARTICIPANTS:

One hundred twelve patients with radiograph-proven pneumonia (mean age 74.6) were enrolled.

MEASUREMENTS:

Functional status and comorbidities were assessed using the Functional Autonomy Measurement System (SMAF) and Charlson Comorbidity Index. Clinical information was used to calculate the Pneumonia Prognostic Index (PPI).

RESULTS:

Eighty-four (75%) patients were functionally independent (FI) before admission, with a SMAF score of 40 or lower. Dementia and aspiration history were higher in the group that was functionally dependent (FD) before admission (P<.001). The FI group had less-severe pneumonia per the PPI and shorter mean LOS+/-standard deviation (5.62+/-0.51 days) than the FD group (11.42+/-2.58, P<.004). The FI group had lower 1-year mortality (19/65, 23%) than the FD group (14/28, 50%), and the difference remained significant after adjusting for Charlson Index and severity of illness (P=.009). All patients lost function after admission, with loss being more pronounced in the FI group (mean change 19.24+/-12.9 vs 4.72+/-6.55, P<.001).

CONCLUSION:

Older adults who were FI before admission were more likely to present with less-severe pneumonia and have a shorter LOS. In addition, further loss of function was common in these patients. Assessment of function before and during hospitalization should be an integral part of clinical evaluation in all older adults with pneumonia.

Comment in

PMID:
16866676
PMCID:
PMC3319410
DOI:
10.1111/j.1532-5415.2006.00797.x
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wiley Icon for PubMed Central
    Loading ...
    Support Center