Age Associated Immune Deficiency, Elderly Infection, Frail Elderly Syndrome, Nutrition Disorders in Old Age, Pneumonia, Sarcopenia
Conditions
Brief summary
The objective is to evaluate if the immune risk phenotype (IRP) in patients who have been admitted for pneumonia predisposes to worse long-term outcomes. In addition, the association between the detected immunological alterations and clinical, functional, nutritional or comorbidity risk factors will be evaluated. If the hypothesis is confirmed, helpful immunological markers will be identified. This will be useful in clinical practice to identify patients who can benefit from an intervention and / or to identify the best time for vaccination. Otherwise, valuable information will be obtained on the interrelation between immunological, clinical, functional and nutritional aspects.
Detailed description
The objective is to evaluate if the immune risk phenotype (IRP) in patients who have been admitted for pneumonia predisposes to worse long-term outcomes. In addition, the association between the detected immunological alterations and clinical, functional, nutritional or comorbidity risk factors will be evaluated. Methodology: Prospective observational study. It will include 149 patients ≥ 65 years admitted for pneumonia. After 30-45 days of pneumonia diagnosis, a complete clinical, functional, nutritional and immunological assessment will be carried out. FRI will be defined as a positive cytomegalovirus serology together with at least one of the following: CD4 / CD8 \<1, CD8 T cells\> 600 / μl or negative CD28 T cells\> 300 / μl15. Mortality and re-admissions at 12 and 18 months will be evaluated. If the hypothesis is confirmed, helpful immunological markers will be identified. This will be useful in clinical practice to identify patients who can benefit from an intervention and / or to identify the best time for vaccination. Otherwise, valuable information will be obtained on the interrelation between immunological, clinical, functional and nutritional aspects.
Interventions
OTHERno intervention
It is an observationa study. There is no intervention.
Sponsors
Fondo de Investigacion Sanitaria
Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patients ≥ 65 years old admitted for pneumonia in the Hospital de la Santa Creu i Sant Pau in Barcelona.
Exclusion criteria
* patients from another acute care hospital * patients with HIV infection * neutropenic patients (neutrophil count \<1000 / mm3) * transplant patients * patients in end-of-life situation * not having written informed consent.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Presence of the immune risk phenotype (IRP) | 18 months | To assess whether the presence of the immune risk phenotype (IRP) in patients who have been admitted for pneumonia predisposes to higher mortality after 18 months of pneumonia. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of readmissions | 18 months | To assess number of readmissions at 18 months. |
| Immunological markers other than IRP | 18 months | To evaluate if immunological markers other than IRP predispose to higher mortality or readmission rates |
| Immunological profile | 18 months | To describe the basic immunological profile of the elderly who have been admitted due to pneumonia and its evolution after the acute phase. |
| Immunological alterations | 18 months | To study if there is an association between IRP and clinical, functional, nutritional, comorbidity risk factors or frailty/sarcopenia. |
Countries
Spain
Outcome results
None listed