Feng Ding-Yun, Zou Xiao-Ling, Zhou Yu-Qi, Wu Wen-Bin, Yang Hai-Ling, Zhang Tian-Tuo
Department of Pulmonary and Critical Care Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Institute of Respiratory Diseases of Sun Yat-Sen University, Guangzhou, People's Republic of China.
Int J Gen Med. 2021 Mar 30;14:1133-1139. doi: 10.2147/IJGM.S300776. eCollection 2021.
Community-acquired pneumonia (CAP) is common among the elderly; it typically has a poor prognosis and high mortality. This study evaluated the factors predicting CAP-related in-hospital mortality in the elderly to identify a simpler and more accurate predictor.
This was a single-center, retrospective study. The data used in this study was collected from all older patients (≥65) with CAP admitted to our hospital between January 2012 and April 2020.
A total of 2028 older patients with CAP were included; 121 (5.97%) died in hospital. Of the patients in the study, 1267 (62.5%) were men and 261 (12.9%) had a history of malignant tumors. After performing univariate and multivariate Cox regression analyses, sex, history of malignant tumor, CURB-65 score, neutrophil-to-lymphocyte ratio (NLR), hemoglobin level, and NLRCURB-65 levels were associated with CAP mortality. By comparing the area under the receiver operating characteristic (ROC) curves of the predicted factors, the NLRCURB-65 level used to predict CAP mortality in the elderly was 0.755, and was superior to other measurements. All included patients were then dichotomized into two groups based on NLRCURB-65 level (≤9.06 and >9.06) according to the ROC analysis. Patients with a high NLRCURB-65 level had higher in-hospital mortality than those with a low NLRCURB-65 level. The two divided groups showed significant differences in age, sex, smoking history, comorbidity, and laboratory findings. This indicates that NLRCURB-65 is a predictive index that could reflect the comprehensive condition of older patients with CAP.
NLR*CURB-65 is a simpler and more accurate predictor of CAP-related in-hospital mortality in the elderly.
社区获得性肺炎（CAP）在老年人中很常见；其通常预后较差且死亡率高。本研究评估了预测老年人CAP相关住院死亡率的因素，以确定一个更简单、更准确的预测指标。
这是一项单中心回顾性研究。本研究使用的数据收集自2012年1月至2020年4月期间我院收治的所有老年（≥65岁）CAP患者。
共纳入2028例老年CAP患者；121例（5.97%）在医院死亡。研究中的患者，1267例（62.5%）为男性，261例（12.9%）有恶性肿瘤病史。进行单因素和多因素Cox回归分析后，性别、恶性肿瘤病史、CURB-65评分、中性粒细胞与淋巴细胞比值（NLR）、血红蛋白水平和NLRCURB-65水平与CAP死亡率相关。通过比较预测因素的受试者工作特征（ROC）曲线下面积，用于预测老年人CAP死亡率的NLRCURB-65水平为0.755，优于其他测量指标。然后根据ROC分析，将所有纳入患者根据NLRCURB-65水平（≤9.06和>9.06）分为两组。NLRCURB-65水平高的患者住院死亡率高于NLRCURB-65水平低的患者。两组在年龄、性别、吸烟史、合并症和实验室检查结果方面存在显著差异。这表明NLRCURB-65是一个可以反映老年CAP患者综合状况的预测指标。
NLR*CURB-65是老年人CAP相关住院死亡率更简单、更准确的预测指标。
