Kitaw Tegene Atamenta, Getie Addisu, Munie Melesse Abiye, Derso Yabibal Asfaw, Asgedom Solomon Gebremichael, Haile Ribka Nigatu
Department of Nursing, College of Health Science Woldia University Woldia Ethiopia.
Department of Nursing, College of Medicine and Health Sciences Debre Markos University Debre Markos Ethiopia.
Health Sci Rep. 2025 Apr 18;8(4):e70666. doi: 10.1002/hsr2.70666. eCollection 2025 Apr.
Severe pneumonia is a leading cause of mortality among older adults, particularly in low-income countries like Ethiopia. Despite treatment advancements, the role of different factors in predicting poor outcomes remains understudied. This study aims to assess early indicators poor outcomes in severe pneumonia among older adults.
A multicenter retrospective cohort study was conducted involving 422 older adults aged over 65 years. Kaplan-Meier survival curves and log-rank tests were utilized to compare survival across categories. Cox regression analysis was performed to evaluate the association between these factors and poor outcomes, while adjusting for potential confounders.
Of the patients, 13.27% (95% CI: 10.18, 16.88) died from severe pneumonia. CHF (AHR = 2.35, 95% CI: 1.23, 4.49), DM (AHR = 2.52, 95% CI: 1.23, 5.14), and COPD (AHR = 2.59, 95% CI: 1.39, 4.81), elevated creatinine (AHR = 1.63, 95% CI: 1.63, 2.69), and low platelet count (AHR = 2.43, 95% CI: 1.78, 5.34) were significantly associated with poor outcomes.
Thrombocytopenia and high creatinine levels may serve as early indicators of poor outcomes in severe pneumonia among older adults. Monitoring these markers is critical for guiding interventions and improving patient outcomes.
重症肺炎是老年人死亡的主要原因，在埃塞俄比亚等低收入国家尤其如此。尽管治疗取得了进展，但不同因素在预测不良结局方面的作用仍未得到充分研究。本研究旨在评估老年人重症肺炎不良结局的早期指标。
进行了一项多中心回顾性队列研究，纳入422名65岁以上的老年人。采用Kaplan-Meier生存曲线和对数秩检验比较各分类的生存率。进行Cox回归分析以评估这些因素与不良结局之间的关联，同时对潜在混杂因素进行校正。
患者中，13.27%（95%CI：10.18，16.88）死于重症肺炎。充血性心力衰竭（AHR = 2.35，95%CI：1.23，4.49）、糖尿病（AHR = 2.52，95%CI：1.23，5.14）、慢性阻塞性肺疾病（AHR = 2.59，95%CI：1.39，4.81）、肌酐升高（AHR = 1.63，95%CI：1.63，2.69）和血小板计数低（AHR = 2.43，95%CI：1.78，5.34）与不良结局显著相关。
血小板减少和高肌酐水平可能是老年人重症肺炎不良结局的早期指标。监测这些指标对于指导干预措施和改善患者结局至关重要。
