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Effects of age, comorbidity and adherence to current antimicrobial guidelines on mortality in hospitalized elderly patients with community-acquired pneumonia

Overview of attention for article published in BMC Infectious Diseases, April 2018
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (55th percentile)

Mentioned by

twitter
4 tweeters

Citations

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24 Dimensions

Readers on

mendeley
80 Mendeley
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Title
Effects of age, comorbidity and adherence to current antimicrobial guidelines on mortality in hospitalized elderly patients with community-acquired pneumonia
Published in
BMC Infectious Diseases, April 2018
DOI 10.1186/s12879-018-3098-5
Pubmed ID
Authors

Xiudi Han, Fei Zhou, Hui Li, Xiqian Xing, Liang Chen, Yimin Wang, Chunxiao Zhang, Xuedong Liu, Lijun Suo, Jinxiang Wang, Guohua Yu, Guangqiang Wang, Xuexin Yao, Hongxia Yu, Lei Wang, Meng Liu, Chunxue Xue, Bo Liu, Xiaoli Zhu, Yanli Li, Ying Xiao, Xiaojing Cui, Lijuan Li, Jay E. Purdy, Bin Cao

Abstract

Limited information exists on the clinical characteristics predictive of mortality in patients aged ≥65 years in many countries. The impact of adherence to current antimicrobial guidelines on the mortality of hospitalized elderly patients with community-acquired pneumonia (CAP) has never been assessed. A total of 3131 patients aged ≥65 years were enrolled from a multi-center, retrospective, observational study initiated by the CAP-China network. Risk factors for death were screened with multivariable logistic regression analysis, with emphasis on the evaluation of age, comorbidities and antimicrobial treatment regimen with regard to the current Chinese CAP guidelines. The mean age of the study population was 77.4 ± 7.4 years. Overall in-hospital and 60-day mortality were 5.7% and 7.6%, respectively; these rates were three-fold higher in those aged ≥85 years than in the 65-74 group (11.9% versus 3.2% for in-hospital mortality and 14.1% versus 4.7% for 60-day mortality, respectively). The mortality was significantly higher among patients with comorbidities compared with those who were otherwise healthy. According to the 2016 Chinese CAP guidelines, 62.1% of patients (1907/3073) received non-adherent treatment. For general-ward patients without risk factors for Pseudomonas aeruginosa (PA) infection (n = 2258), 52.3% (1094/2090) were over-treated, characterized by monotherapy with an anti-pseudomonal β-lactam or combination with fluoroquinolone + β-lactam; while 71.4% of intensive care unit (ICU) patients (120/168) were undertreated, without coverage of atypical bacteria. Among patients with risk factors for PA infection (n = 815), 22.9% (165/722) of those in the general ward and 74.2% of those in the ICU (69/93) were undertreated, using regimens without anti-pseudomonal activity. The independent predictors of 60-day mortality were age, long-term bedridden status, congestive heart failure, CURB-65, glucose, heart rate, arterial oxygen saturation (SaO2) and albumin levels. Overtreatment in general-ward patients and undertreatment in ICU patients were critical problems. Compliance with Chinese guidelines will require fundamental changes in standard-of-care treatment patterns. The data included herein may facilitate early identification of patients at increased risk of mortality. The study was registered at ClinicalTrials.gov ( NCT02489578 ).

Twitter Demographics

The data shown below were collected from the profiles of 4 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 80 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 80 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 7 9%
Researcher 7 9%
Student > Master 7 9%
Other 6 8%
Student > Doctoral Student 6 8%
Other 15 19%
Unknown 32 40%
Readers by discipline Count As %
Medicine and Dentistry 23 29%
Nursing and Health Professions 6 8%
Pharmacology, Toxicology and Pharmaceutical Science 2 3%
Social Sciences 2 3%
Agricultural and Biological Sciences 1 1%
Other 6 8%
Unknown 40 50%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 August 2020.
All research outputs
#10,292,881
of 18,772,620 outputs
Outputs from BMC Infectious Diseases
#2,358
of 6,554 outputs
Outputs of similar age
#128,887
of 289,905 outputs
Outputs of similar age from BMC Infectious Diseases
#1
of 1 outputs
Altmetric has tracked 18,772,620 research outputs across all sources so far. This one is in the 44th percentile – i.e., 44% of other outputs scored the same or lower than it.
So far Altmetric has tracked 6,554 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.5. This one has gotten more attention than average, scoring higher than 63% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 289,905 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 55% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them