P189 Hospital acquired pneumonia and frailty: the new old age problem to solve

Abstract

<h3>Introduction</h3> Hospital acquired pneumonia (HAP) is a common but poorly researched nosocomial infection.¹ A review of the literature found scanty and contradictory evidence for risk factors for mortality from HAP. Frailty is a condition that results from a decline in physiological reserve with age and has been deemed to be the biggest problem resulting from an ageing population.² <h3>Objectives</h3> This novel study aimed to investigate if there is a relationship between frailty score and mortality risk from HAP. It also aimed to study if frailty score affects how HAP presents. <h3>Methods</h3> Data were collected from two medical wards at a district general hospital over a five month period. Comparisons of admission frailty scores between those dead and alive at 7 and 30 days after diagnosis of HAP were performed. All patients with HAP had their admission frailty scores, time from admission to diagnosis, observations and inflammatory markers recorded. Spearman’s rank was used to assess for significant correlations. <h3>Results</h3> The mean admission frailty score for those dead was higher than those alive at both 7 days (6.80, 6.41) and 30 days (7.00, 6.30). Frailty score was not significantly correlated with any of the following measurements at time of HAP diagnosis: time from admission (rho=0.246, p=0.142), Early Warning Score (rho=-0.058, p=0.732), respiratory rate (rho=0.053, p=0.758), heart rate (rho=-0.276, p=0.098), temperature (-0.163, p=0.373), systolic blood pressure (rho=-0.051, p=0.763), diastolic blood pressure (rho=-0.157, p=0.353), white blood cell count (rho=0.205, p=0.252), C-reactive protein (rho=0.057, p=0.744). <h3>Conclusion</h3> The findings of this study suggest that an individual with a higher frailty score at admission is more likely to die should they acquire a HAP during their time in hospital. Further research is urgently needed to further assess the predictive power of frailty score for mortality risk. Knowledge that frailty score does not affect how patients present with HAP also aids healthcare professionals in caring for hospital inpatients. <h3>References</h3> Burton L A, <i>et al</i>. Hospital-acquired pneumonia incidence and diagnosis in older patients. <i>Age Ageing</i>. 2016; <b>45</b>(1): 171–174. Clegg A, <i>et al</i>. Frailty in elderly people. <i>Lancet</i>. 2013; <b>381</b>: 752–762.