Related Experiment Video
Updated: Feb 28, 2026
Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
Frailty as a Key Determinant of In-Hospital Mortality in 58,040 Patients with Community-Acquired Pneumonia: Evidence
Yeny Concha-Cisternas1,2, Manuel Vásquez-Muñoz3,4, Rodrigo Yañez-Sepúlveda5,6
1Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca 3460000, Chile.
Abstract:
Background: Pneumonia is a leading cause of hospitalization and death among older adults, reflecting both patient vulnerability and the quality of acute care. However, evidence from Latin America remains limited. Objective: to examine the association between frailty level assessed using the HFRS and in-hospital mortality among older adults hospitalized with community-acquired pneumonia (CAP). Methods: We conducted a retrospective cohort study using the Chilean National Health Fund (Fondo Nacional de Salud, FONASA) database, including patients aged ≥ 60 years hospitalized with CAP (ICD-10 codes J12-J18) between 2019 and 2024. Variables analyzed included age, sex, frailty level assessed by the Hospital Frailty Risk Score (HFRS), comorbidity burden (Charlson Comorbidity Index), Diagnosis-Related Group (DRG) severity level, and relative weight. Survival was analyzed using Kaplan-Meier curves and log-rank tests. Multivariable Cox proportional hazards models estimated adjusted hazard ratios (HR) with 95% confidence intervals (CI). Results: The cohort comprised 58,040 patients (51.2% women). Overall, in-hospital mortality was 19.3%. Independent predictors of mortality included advanced age (≥90 years: HR = 2.41; 95% CI: 2.27-2.56), male sex (HR = 1.10; 95% CI: 1.06-1.14), high frailty risk (HR = 1.57; 95% CI: 1.47-1.68), and greater DRG severity (per level: HR = 1.66; 95% CI: 1.58-1.73). The Charlson Comorbidity Index lost significance after adjustment. Conclusions: Frailty emerged as a strong and independent determinant of in-hospital mortality in older adults with CAP. Systematic frailty assessment combined with comorbidity indices could improve risk stratification and guide more personalized, evidence-based clinical management in acute care settings.
Related Concept Videos
01:30Pneumonia III: Complications and Assessment
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:29Pneumonia II: Pathophysiology
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...