Analysis of prognostic factors for hospitalized patients aged 95 years and over with community-acquired pneumonia

Abstract

Objective To investigate clinical characteristics and prognostic factors for hospitalized patients aged 95 years and older with community-acquired pneumonia(CAP). Methods A retrospective study was conducted on CAP patients aged ≥95 years hospitalized in Jiangsu Province Hospital or Jiangsu Province Hospital of TCM between January 2014 and January 2018.Clinical characteristics were collected.The shock index(SI), Charlson comorbidity index(CCI), neutrophil/lymphocyte rate (NLR)and CURB-65 score were calculated.The predictive value of the related factors was evaluated by using the Logistic regression model and the subjects' receiver operating characteristic curve (ROC). Results A total of 205 cases were enrolled in this study.The hospital mortality rate was 36.1%(73/205). The heart rate, white blood cell count, mononuclear cell count, neutrophil count(N), NLR, fasting blood glucose, blood urea nitrogen(BUN)and D-dimer results revealed significant differences between the death group and the survival group(all P<0.05). Scores of CCI and CURB-65 were higher in the death group than in the survival group[(2.90±1.88)vs.(1.91 ±1.81), (2.34±0.69)vs.(1.76±0.69), both P<0.05]. Multivariate Logistic analysis showed that heart rate≥84.73 beat per minute(OR=2.452, 95%CI: 1.054~5.702), NLR≥11.43(OR=5.499, 95%CI: 2.132~14.180), BUN≥12.95 mmol/L(OR=2.546, 95%CI: 1.025~6.319), CCI≥3(OR=4.453, 95%CI: 1.191~10.113), CURB-65≥2 scores(OR=3.888, 95%CI: 1.288~11.735)and respiratory failure(OR=2.875, 95%CI: 1.204~6.806)were risk factors for death in hospitalized elderly aged 95 years and older with CAP.ROC analysis showed that CCI combined with the CURB-65 score or CCI combined with the CURB-65 score plus NLR could better predict the in-hospital mortality of elderly patients than CCI or the CURB-65 score used alone. Conclusions Hospitalized patients aged≥95 with CAP are prone to multiple complications and high mortality rates.Combined application of multiple evaluation systems and indicators can improve the prognosis of outcomes for patients in this age group. Key words: Pneumonia; Hospitalization