Combining a Frailty Index Based on Laboratory Data and Pneumonia Severity Assessments to Predict In-Hospital Outcomes in Older Adults with Community-Acquired Pneumonia. Zan, Y. M., Zheng, T. P., Wang, Y., Shao, J. F., Wang, Z. Y., Zhao, W. H., Wu, J. Q., & Xu, W. The Journal of nutrition, health and aging, 27(4):270–276, April, 2023. ![Combining a Frailty Index Based on Laboratory Data and Pneumonia Severity Assessments to Predict In-Hospital Outcomes in Older Adults with Community-Acquired Pneumonia [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex Objectives Due to the increased morbidity, mortality, and cost of community-acquired pneumonia (CAP) in older people, strategies directed at improving disease evaluation and prevention are imperative. We independently compared the 30-day in-hospital mortality prediction ability of a frailty index based on laboratory data (FI-Lab) with that of the CURB-65 and the Pneumonia Severity Index (PSI) and then proposed combining them to further improve prediction efficiency. Design Retrospective cohort study. Setting and Participants Patients aged ≥ 65 years (n = 2039) with CAP who were admitted to Jiangsu Provincial People's Hospital of Nanjing Medical University and Jiangsu Provincial Hospital of Chinese Medicine from January 2019 to June 2022. Measures The 29-item FI-Lab, PSI and, CURB-65 were administered at admission. We defined frailty by the cut-off value of the FI-Lab score (\textgreater 0.43). Multivariable logistic regression analysis, together with the calculation of the area under the receiver operating characteristic curve (ROC-AUC), was conducted to identify stratified risks and relationships between the three indices and 30-day mortality. Participants were divided into the following three groups based on age: 65–74 years, 75–84 years, and ≥ 85 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality due to frailty were calculated. Results A total of 495 participants ranging from 65 to 100 years of age were ultimately included and divided into age groups (65–74 years, n = 190, 38.4%; 75–84 years, n = 183, 37.0%; ≥ 85 years, n = 122, 24.6%). A total of 142 (28.7%) of the 495 patients were defined as having frailty. All three scores tested in this study were significantly associated with 30-day mortality in the total sample. The ORs were as follows: 1.06 (95% CI: 1.03–1.09, P \textless 0.001) and 2.33 (95% CI: 1.26–4.31, P = 0.007) for the FI-Lab when the score was treated as a continuous and categorical variable, respectively; 1.04 (95% CI: 1.02–1.05, P \textless 0.001) for the PSI; and 3.70 (95% CI: 2.48–5.50, P \textless 0.001) for the CURB-65. In the total sample, the ROC-AUCs were 0.783 (95% CI: 0.744–0.819) for the FI-Lab, 0.812 (95% CI: 0.775–0.845) for the PSI, and 0.799 (95% CI: 0.761–0.834) for the CURB-65 (P \textless 0.001). The ROC-AUC slightly improved when the FI-Lab was added to the PSI (AUC 0.850, 95% CI: 0.809–0.892, P = 0.031) and to the CURB-65 (AUC 0.839, 95% CI: 0.794–0.885, P = 0.002). Older patients with frailty showed a higher risk of in-hospital mortality, with an HR of 2.25 (95% CI: 1.14–3.58, P \textless 0.001). Conclusion and Implications The FI-Lab seems to generate simple and readily available data, suggesting that it could be a useful complement to the CURB-65 and the PSI as effective predictors of 30-day mortality due to CAP in older populations.
@article{zan_combining_2023,
title = {Combining a {Frailty} {Index} {Based} on {Laboratory} {Data} and {Pneumonia} {Severity} {Assessments} to {Predict} {In}-{Hospital} {Outcomes} in {Older} {Adults} with {Community}-{Acquired} {Pneumonia}},
volume = {27},
issn = {1279-7707},
url = {https://www.sciencedirect.com/science/article/pii/S1279770723002920},
doi = {10.1007/s12603-023-1905-1},
abstract = {Objectives
Due to the increased morbidity, mortality, and cost of community-acquired pneumonia (CAP) in older people, strategies directed at improving disease evaluation and prevention are imperative. We independently compared the 30-day in-hospital mortality prediction ability of a frailty index based on laboratory data (FI-Lab) with that of the CURB-65 and the Pneumonia Severity Index (PSI) and then proposed combining them to further improve prediction efficiency.
Design
Retrospective cohort study.
Setting and Participants
Patients aged ≥ 65 years (n = 2039) with CAP who were admitted to Jiangsu Provincial People's Hospital of Nanjing Medical University and Jiangsu Provincial Hospital of Chinese Medicine from January 2019 to June 2022.
Measures
The 29-item FI-Lab, PSI and, CURB-65 were administered at admission. We defined frailty by the cut-off value of the FI-Lab score ({\textgreater} 0.43). Multivariable logistic regression analysis, together with the calculation of the area under the receiver operating characteristic curve (ROC-AUC), was conducted to identify stratified risks and relationships between the three indices and 30-day mortality. Participants were divided into the following three groups based on age: 65–74 years, 75–84 years, and ≥ 85 years. Hazard ratios (HRs) and 95\% confidence intervals (CIs) for mortality due to frailty were calculated.
Results
A total of 495 participants ranging from 65 to 100 years of age were ultimately included and divided into age groups (65–74 years, n = 190, 38.4\%; 75–84 years, n = 183, 37.0\%; ≥ 85 years, n = 122, 24.6\%). A total of 142 (28.7\%) of the 495 patients were defined as having frailty. All three scores tested in this study were significantly associated with 30-day mortality in the total sample. The ORs were as follows: 1.06 (95\% CI: 1.03–1.09, P {\textless} 0.001) and 2.33 (95\% CI: 1.26–4.31, P = 0.007) for the FI-Lab when the score was treated as a continuous and categorical variable, respectively; 1.04 (95\% CI: 1.02–1.05, P {\textless} 0.001) for the PSI; and 3.70 (95\% CI: 2.48–5.50, P {\textless} 0.001) for the CURB-65. In the total sample, the ROC-AUCs were 0.783 (95\% CI: 0.744–0.819) for the FI-Lab, 0.812 (95\% CI: 0.775–0.845) for the PSI, and 0.799 (95\% CI: 0.761–0.834) for the CURB-65 (P {\textless} 0.001). The ROC-AUC slightly improved when the FI-Lab was added to the PSI (AUC 0.850, 95\% CI: 0.809–0.892, P = 0.031) and to the CURB-65 (AUC 0.839, 95\% CI: 0.794–0.885, P = 0.002). Older patients with frailty showed a higher risk of in-hospital mortality, with an HR of 2.25 (95\% CI: 1.14–3.58, P {\textless} 0.001).
Conclusion and Implications
The FI-Lab seems to generate simple and readily available data, suggesting that it could be a useful complement to the CURB-65 and the PSI as effective predictors of 30-day mortality due to CAP in older populations.},
number = {4},
urldate = {2026-05-19},
journal = {The Journal of nutrition, health and aging},
author = {Zan, Y. M. and Zheng, T. P. and Wang, Y. and Shao, J. F. and Wang, Z. Y. and Zhao, W. H. and Wu, J. Q. and Xu, Wei},
month = apr,
year = {2023},
keywords = {30-day mortality, CURB-65, Community-acquired pneumonia, Frailty index, Pneumonia Severity Index},
pages = {270--276},
}
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{"_id":"8KGWMPht7uuMY3Sv4","bibbaseid":"zan-zheng-wang-shao-wang-zhao-wu-xu-combiningafrailtyindexbasedonlaboratorydataandpneumoniaseverityassessmentstopredictinhospitaloutcomesinolderadultswithcommunityacquiredpneumonia-2023","author_short":["Zan, Y. M.","Zheng, T. P.","Wang, Y.","Shao, J. F.","Wang, Z. Y.","Zhao, W. H.","Wu, J. Q.","Xu, W."],"bibdata":{"bibtype":"article","type":"article","title":"Combining a Frailty Index Based on Laboratory Data and Pneumonia Severity Assessments to Predict In-Hospital Outcomes in Older Adults with Community-Acquired Pneumonia","volume":"27","issn":"1279-7707","url":"https://www.sciencedirect.com/science/article/pii/S1279770723002920","doi":"10.1007/s12603-023-1905-1","abstract":"Objectives Due to the increased morbidity, mortality, and cost of community-acquired pneumonia (CAP) in older people, strategies directed at improving disease evaluation and prevention are imperative. We independently compared the 30-day in-hospital mortality prediction ability of a frailty index based on laboratory data (FI-Lab) with that of the CURB-65 and the Pneumonia Severity Index (PSI) and then proposed combining them to further improve prediction efficiency. Design Retrospective cohort study. Setting and Participants Patients aged ≥ 65 years (n = 2039) with CAP who were admitted to Jiangsu Provincial People's Hospital of Nanjing Medical University and Jiangsu Provincial Hospital of Chinese Medicine from January 2019 to June 2022. Measures The 29-item FI-Lab, PSI and, CURB-65 were administered at admission. We defined frailty by the cut-off value of the FI-Lab score (\\textgreater 0.43). Multivariable logistic regression analysis, together with the calculation of the area under the receiver operating characteristic curve (ROC-AUC), was conducted to identify stratified risks and relationships between the three indices and 30-day mortality. Participants were divided into the following three groups based on age: 65–74 years, 75–84 years, and ≥ 85 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality due to frailty were calculated. Results A total of 495 participants ranging from 65 to 100 years of age were ultimately included and divided into age groups (65–74 years, n = 190, 38.4%; 75–84 years, n = 183, 37.0%; ≥ 85 years, n = 122, 24.6%). A total of 142 (28.7%) of the 495 patients were defined as having frailty. All three scores tested in this study were significantly associated with 30-day mortality in the total sample. The ORs were as follows: 1.06 (95% CI: 1.03–1.09, P \\textless 0.001) and 2.33 (95% CI: 1.26–4.31, P = 0.007) for the FI-Lab when the score was treated as a continuous and categorical variable, respectively; 1.04 (95% CI: 1.02–1.05, P \\textless 0.001) for the PSI; and 3.70 (95% CI: 2.48–5.50, P \\textless 0.001) for the CURB-65. In the total sample, the ROC-AUCs were 0.783 (95% CI: 0.744–0.819) for the FI-Lab, 0.812 (95% CI: 0.775–0.845) for the PSI, and 0.799 (95% CI: 0.761–0.834) for the CURB-65 (P \\textless 0.001). The ROC-AUC slightly improved when the FI-Lab was added to the PSI (AUC 0.850, 95% CI: 0.809–0.892, P = 0.031) and to the CURB-65 (AUC 0.839, 95% CI: 0.794–0.885, P = 0.002). Older patients with frailty showed a higher risk of in-hospital mortality, with an HR of 2.25 (95% CI: 1.14–3.58, P \\textless 0.001). Conclusion and Implications The FI-Lab seems to generate simple and readily available data, suggesting that it could be a useful complement to the CURB-65 and the PSI as effective predictors of 30-day mortality due to CAP in older populations.","number":"4","urldate":"2026-05-19","journal":"The Journal of nutrition, health and aging","author":[{"propositions":[],"lastnames":["Zan"],"firstnames":["Y.","M."],"suffixes":[]},{"propositions":[],"lastnames":["Zheng"],"firstnames":["T.","P."],"suffixes":[]},{"propositions":[],"lastnames":["Wang"],"firstnames":["Y."],"suffixes":[]},{"propositions":[],"lastnames":["Shao"],"firstnames":["J.","F."],"suffixes":[]},{"propositions":[],"lastnames":["Wang"],"firstnames":["Z.","Y."],"suffixes":[]},{"propositions":[],"lastnames":["Zhao"],"firstnames":["W.","H."],"suffixes":[]},{"propositions":[],"lastnames":["Wu"],"firstnames":["J.","Q."],"suffixes":[]},{"propositions":[],"lastnames":["Xu"],"firstnames":["Wei"],"suffixes":[]}],"month":"April","year":"2023","keywords":"30-day mortality, CURB-65, Community-acquired pneumonia, Frailty index, Pneumonia Severity Index","pages":"270–276","bibtex":"@article{zan_combining_2023,\n\ttitle = {Combining a {Frailty} {Index} {Based} on {Laboratory} {Data} and {Pneumonia} {Severity} {Assessments} to {Predict} {In}-{Hospital} {Outcomes} in {Older} {Adults} with {Community}-{Acquired} {Pneumonia}},\n\tvolume = {27},\n\tissn = {1279-7707},\n\turl = {https://www.sciencedirect.com/science/article/pii/S1279770723002920},\n\tdoi = {10.1007/s12603-023-1905-1},\n\tabstract = {Objectives\nDue to the increased morbidity, mortality, and cost of community-acquired pneumonia (CAP) in older people, strategies directed at improving disease evaluation and prevention are imperative. We independently compared the 30-day in-hospital mortality prediction ability of a frailty index based on laboratory data (FI-Lab) with that of the CURB-65 and the Pneumonia Severity Index (PSI) and then proposed combining them to further improve prediction efficiency.\nDesign\nRetrospective cohort study.\nSetting and Participants\nPatients aged ≥ 65 years (n = 2039) with CAP who were admitted to Jiangsu Provincial People's Hospital of Nanjing Medical University and Jiangsu Provincial Hospital of Chinese Medicine from January 2019 to June 2022.\nMeasures\nThe 29-item FI-Lab, PSI and, CURB-65 were administered at admission. We defined frailty by the cut-off value of the FI-Lab score ({\\textgreater} 0.43). Multivariable logistic regression analysis, together with the calculation of the area under the receiver operating characteristic curve (ROC-AUC), was conducted to identify stratified risks and relationships between the three indices and 30-day mortality. Participants were divided into the following three groups based on age: 65–74 years, 75–84 years, and ≥ 85 years. Hazard ratios (HRs) and 95\\% confidence intervals (CIs) for mortality due to frailty were calculated.\nResults\nA total of 495 participants ranging from 65 to 100 years of age were ultimately included and divided into age groups (65–74 years, n = 190, 38.4\\%; 75–84 years, n = 183, 37.0\\%; ≥ 85 years, n = 122, 24.6\\%). A total of 142 (28.7\\%) of the 495 patients were defined as having frailty. All three scores tested in this study were significantly associated with 30-day mortality in the total sample. The ORs were as follows: 1.06 (95\\% CI: 1.03–1.09, P {\\textless} 0.001) and 2.33 (95\\% CI: 1.26–4.31, P = 0.007) for the FI-Lab when the score was treated as a continuous and categorical variable, respectively; 1.04 (95\\% CI: 1.02–1.05, P {\\textless} 0.001) for the PSI; and 3.70 (95\\% CI: 2.48–5.50, P {\\textless} 0.001) for the CURB-65. In the total sample, the ROC-AUCs were 0.783 (95\\% CI: 0.744–0.819) for the FI-Lab, 0.812 (95\\% CI: 0.775–0.845) for the PSI, and 0.799 (95\\% CI: 0.761–0.834) for the CURB-65 (P {\\textless} 0.001). The ROC-AUC slightly improved when the FI-Lab was added to the PSI (AUC 0.850, 95\\% CI: 0.809–0.892, P = 0.031) and to the CURB-65 (AUC 0.839, 95\\% CI: 0.794–0.885, P = 0.002). Older patients with frailty showed a higher risk of in-hospital mortality, with an HR of 2.25 (95\\% CI: 1.14–3.58, P {\\textless} 0.001).\nConclusion and Implications\nThe FI-Lab seems to generate simple and readily available data, suggesting that it could be a useful complement to the CURB-65 and the PSI as effective predictors of 30-day mortality due to CAP in older populations.},\n\tnumber = {4},\n\turldate = {2026-05-19},\n\tjournal = {The Journal of nutrition, health and aging},\n\tauthor = {Zan, Y. M. and Zheng, T. P. and Wang, Y. and Shao, J. F. and Wang, Z. Y. and Zhao, W. H. and Wu, J. Q. and Xu, Wei},\n\tmonth = apr,\n\tyear = {2023},\n\tkeywords = {30-day mortality, CURB-65, Community-acquired pneumonia, Frailty index, Pneumonia Severity Index},\n\tpages = {270--276},\n}\n\n\n\n\n\n\n\n","author_short":["Zan, Y. M.","Zheng, T. P.","Wang, Y.","Shao, J. F.","Wang, Z. Y.","Zhao, W. H.","Wu, J. 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