医养结合机构高龄社区获得性肺炎患者预后影响因素分析OACSTPCD

Objective To analyze the clinical features and prognostic factors of community-acquired pneumonia(CAP)of elderly patients in medical and nursing institutions.Methods Ninety-six CAP patients aged≥80 years admitted to Department of Geriatrics of the Second Hospital of Shandong University South Branch(Jinan Shande Nursing Home)were enrolled.According to the 6-month survival,all patients were divided into the survival group and death group.Baseline data and laboratory data were collected in two groups.CURB-65 scores were calculated and compared between two groups.The risk factors of clinical prognosis were identified by logistic regression analysis.The prognostic value of these risk factors was analyzed by using the receiver operating characteristic(ROC)curve.Results Compared with the survival group,the proportion of patients with hypertension,coronary atherosclerotic heart disease and hemiplegia was higher,and C-reactive protein(CRP),white blood cell count(WBC),D-dimer,N-terminal pro-brain natriuretic peptide(NT-proBNP),urea nitrogen(BUN)and CURB-65 scores were higher in the death group(all P<0.05).ROC curve showed that the sensitivity,specificity and area under the ROC curve(AUC)of combined detection of CRP,NT-proBNP and CURB-65 for predicting the prognosis of elderly patients with CAP were 72.7%,84.6%and 0.860(95%CI 0.790-0.933),respectively.Conclusions CRP,NT-proBNP and CURB-65 score are correlated with clinical prognosis of elderly CAP patients in medical and nursing institutions.Combined detection of these three indicators can improve the prognostic value in elderly CAP patients.