The Predictive Significance Of Enhanced CURB Score In Community Acquired Pneumonia Combined With Immune Dysfunction

Objective To explore the predictive value of enhanced CURB score in the prognosis of community-acquired pneumonia(CAP)with immune dysfunctionMethods Retrospective study of 156 cases of CAP with immune dysfunction disease patients who was treated by Anhui Medical University First Affiliated Hospital from January 2012 to July 2016.Divided the patients into survival group and death group and comparing the basic clinical situation of two groups;Draw the Receiver Operator Characteristic(ROC)curve by the calculations of enhanced CURB score,CURB-65 score and q SOFA score which use the 28 days prognosis of patients as the clinical observation endpoint.Analyze the predictive value of three scoring tools in the prognosis of communityacquired pneumonia(CAP)with immune dysfunction patients by comparing the Area Under the Curve(AUC).Results 1.Survival group and death group were between gender,hospitalization,respiratory rate,mean arterial pressure,white blood cell count,diabetes,connective tissue disease,tumor,use of immune dysfunction agents,hormones in patients with the percentage difference between were not statistically significant(P>0.05).2.The survival group and death group of patients age,altered state of consciousness,blood urea nitrogen,the percentage of neutrophils,C-reactive protein,combined with brain metastases in patients with stroke,percentage,CURB-65 score,q SOFA score, enhance CURB score,comparison between the differences were statistically significant(P<0.05).3.the CURB-65 score’s AUC is 0.816,Sensitivity is 81.82%,Specificity is 65.67%,the best cut-off values is 1,p<0.01;the q SOFA score’s AUC is 0.642,Sensitivity is 54.5%,Specificity is 73.1%,the best cut-off values is 0,p<0.01.There is a significant difference between q SOFA score and CURB-65,q SOFA score and enhanced CURB score,no significant difference between enhanced CURB score and CURB-65 score.Conclusions 1.The enhance CURB score has preferable predictive value in evaluating the prognosis of CAP with immune dysfunction patients,has low Sensitivity while the Specificity is superior to CURB-65 score and q SOFA score.2.The mortality of CAP combined immune dysfunction patients increased with the increase of the results of the three scores.