Song Yansha, Wang Xiaocen, Lang Ke, Wei Tingting, Luo Jinlong, Song Yuanlin, Yang Dong
Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
Shanghai Key Laboratory of Lung Inflammation and Injury, Shanghai, People's Republic of China.
J Inflamm Res. 2022 Jul 21;15:4149-4158. doi: 10.2147/JIR.S369319. eCollection 2022.
There were few studies on the mortality of severe community-acquired pneumonia (SCAP) in elderly people. Early prediction of 28-day mortality of hospitalized patients will help in the clinical management of elderly patients (age ≥65 years) with SCAP, but a prediction model that is reliable and valid is still lacking.
The 292 elderly patients with SCAP met the criteria defined by the American Thoracic Society from 33 hospitals in China. Clinical parameters were analyzed by the use of univariable and multivariable logistic regression analysis. A nomogram to predict the 28-day mortality in elderly patients with SCAP was constructed and evaluated using the area under the receiver operating characteristic curve (AUC) and internally verified using the Bootstrap method.
A total of 292 elderly patients (227 surviving and 65 died within 28 days) were included in the analysis. Age, Glasgow score, blood platelet, and blood urea nitrogen values were found to be significantly associated with 28-day mortality in elderly patients with SCAP. The AUC of the nomogram was 0.713 and the calibration curve for 28-day mortality also showed high coherence between the predicted and actual probability of mortality.
This study provides a nomogram containing age, Glasgow score, blood platelet, and blood urea nitrogen values that can be conveniently used to predict 28-day mortality in elderly patients with SCAP. This model has the potential to assist clinicians in evaluating prognosis of patients with SCAP.
关于老年人重症社区获得性肺炎（SCAP）死亡率的研究较少。对住院患者28天死亡率进行早期预测将有助于对老年（年龄≥65岁）SCAP患者进行临床管理，但仍缺乏可靠且有效的预测模型。
292例老年SCAP患者符合美国胸科学会定义的标准，来自中国33家医院。通过单变量和多变量逻辑回归分析对临床参数进行分析。构建了一个预测老年SCAP患者28天死亡率的列线图，并使用受试者操作特征曲线下面积（AUC）进行评估，并用Bootstrap法进行内部验证。
共有292例老年患者纳入分析（227例存活，65例在28天内死亡）。发现年龄、格拉斯哥评分、血小板和血尿素氮值与老年SCAP患者的28天死亡率显著相关。列线图的AUC为0.713，28天死亡率的校准曲线也显示预测死亡率与实际死亡率之间具有高度一致性。
本研究提供了一个包含年龄、格拉斯哥评分、血小板和血尿素氮值的列线图，可方便地用于预测老年SCAP患者的28天死亡率。该模型有可能协助临床医生评估SCAP患者的预后。
