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降钙素原联合 CURB-65 评分对社区获得性肺炎 90 天病死率的预测价值。

Prediction value of procalcitonin combining CURB-65 for 90-day mortality in community-acquired pneumonia.

机构信息

Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China.

The Respiratory Department, Cang Zhou People's Hospital, China.

出版信息

Expert Rev Respir Med. 2021 May;15(5):689-696. doi: 10.1080/17476348.2021.1865810. Epub 2020 Dec 29.

DOI:10.1080/17476348.2021.1865810
PMID:33336607
Abstract

: Due to its high mortality rate, immediate and reliable severity assessment and accurate prediction of prognosis at hospital admission is critical for the management of community-acquired pneumonia (CAP) patients.: Consecutive patients with primary diagnosis of CAP and hospitalized at our hospital from January 2013 to December 2015 were screened for this retrospective study. Demographic information, clinical and laboratory examination, severity model scoring, and 90-day outcomes were studied. Area under the curve (AUC) of receiver operating characteristic curve (ROC) was analyzed to compare the predictive value of different prognostic scoring methods.: 2099 CAP patients with a median age of 60 (IQR 44.0-73.0) years-old were included in this study. Median length of stay was 10 days (IQR 8.0-13.0). The all-cause 90-day mortality was found in 2.19% (46/2099) of all patients. PCT was identified as an independent predictor for the prognosis of CAP patients. CURB-65 in combination with PCT outperformed other predictive methods in 90-day mortality with the optimal AUC of 0.900 and Youden's Index of 0.706.: PCT is a good marker for the assessment of severity and 90-day mortality of CAP patients. The combination of PCT and CURB-65 was more accurate than other prognostic models in predicting 90-day mortality.

摘要

: 由于其高死亡率,在入院时立即进行可靠的严重程度评估和准确预测预后对于社区获得性肺炎 (CAP) 患者的管理至关重要。: 本回顾性研究筛选了 2013 年 1 月至 2015 年 12 月期间在我院因原发性 CAP 住院的连续患者。研究了人口统计学信息、临床和实验室检查、严重程度模型评分以及 90 天结局。分析受试者工作特征曲线 (ROC) 的曲线下面积 (AUC) 以比较不同预后评分方法的预测价值。: 本研究共纳入 2099 例 CAP 患者,中位年龄为 60(IQR 44.0-73.0)岁。中位住院时间为 10 天(IQR 8.0-13.0)。所有患者的 90 天全因死亡率为 2.19%(46/2099)。降钙素原被确定为 CAP 患者预后的独立预测因子。CURB-65 联合降钙素原在 90 天死亡率方面的预测优于其他预测方法,AUC 最佳为 0.900,Youden 指数为 0.706。: 降钙素原是评估 CAP 患者严重程度和 90 天死亡率的良好标志物。PCT 和 CURB-65 的联合应用比其他预后模型更能准确预测 90 天死亡率。

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