Department of Geriatric Medicine, Kanazawa Medical University Himi Municipal Hospital, Toyama, Japan.
Department of Geriatric Medicine, Kanazawa Medical University, Kahoku-gun, Japan.
Geriatr Gerontol Int. 2024 Jun;24(6):571-576. doi: 10.1111/ggi.14887. Epub 2024 May 1.
Whether serum concentration of procalcitonin (PCT), brain natriuretic peptide (BNP) and albumin (Alb) have an association with the outcome of hospitalized older patients is unclear. We investigated clinical outcomes and any predictive factors in hospitalized Japanese older patients with a risk of infection.
In the retrospective study, 820 Japanese patients were followed up for 30 days or until death. During the observation period, 656 patients survived and 164 patients died. The predictive factors of death were analyzed according to demographic and clinical variables.
The survival rate was decreased as the serum PCT increased from <0.5 to ≥10 ng/mL, as was also the case with BNP from <300 to ≥300 pg./mL, whereas low Alb (<2.5 g/dL) showed a lower survival rate than high Alb (≥2.5 g/dL; P < 0.01). Using the Cox regression model, the multivariable-adjusted hazard ratios (95% confidence interval) were as follows: PCT 0.5-2 versus <0.5 ng/mL: 1.61(1.04-2.49), PCT 2-10 versus <0.5 ng/mL: 1.91(1.15-3.16), PCT ≥10 versus <0.5 ng/mL: 2.90(1.84-4.59), high BNP 1.26 (0.89-1.76) and low Alb 0.68 (0.52-0.87). The mortality rate increased as the number of scores (PCT + BNP + Alb) increased.
Concentration-dependent high PCT, high BNP and low Alb were positive risk factors associated with poor prognosis in hospitalized older patients with a risk of infection. Geriatr Gerontol Int 2024; 24: 571-576.
目前尚不清楚血清降钙素原（PCT）、脑利钠肽（BNP）和白蛋白（Alb）的浓度与住院老年患者的预后是否有关。我们研究了患有感染风险的日本老年住院患者的临床结局和任何预测因素。
在这项回顾性研究中，820 名日本患者接受了 30 天或直至死亡的随访。在观察期间，656 名患者存活，164 名患者死亡。根据人口统计学和临床变量分析死亡的预测因素。
随着血清 PCT 从<0.5 增加到≥10ng/ml，生存率下降，BNP 从<300 增加到≥300pg/ml 也是如此，而低 Alb(<2.5g/dL)的生存率低于高 Alb(≥2.5g/dL；P<0.01)。使用 Cox 回归模型，多变量调整后的危险比（95%置信区间）如下：PCT 0.5-2 与<0.5ng/ml 相比：1.61(1.04-2.49)，PCT 2-10 与<0.5ng/ml 相比：1.91(1.15-3.16)，PCT≥10 与<0.5ng/ml 相比：2.90(1.84-4.59)，高 BNP 1.26(0.89-1.76)和低 Alb 0.68(0.52-0.87)。随着评分（PCT+BNP+Alb）数目的增加，死亡率增加。
浓度依赖性高 PCT、高 BNP 和低 Alb 是与感染风险的住院老年患者预后不良相关的阳性危险因素。
