Analysis Of Influencing Factors Of Mortality In Elderly Patients With Community-Acquired Pneumonia

BackgroundCommumity-acquired pneumonia is a common disease of respiratory system,and it is also one of the main causes of death among the elderly in the world.With the aging trend of population in our country,the elderly patients with community-acquired pneumonia are increasing rapidly.Most of the elderly patients are complicated with underlying diseases,the clinical manifestations are not typical,so it is easy to be misdiagnosed and mistreated.The pathogenetic condition of elderly patients often develop faster and with higher mortality,it has an important practical significance to find the influencing factors of elderly community-acquired pneumonia,with early diagnosis of pulmonary disease and timely implementation of targeted therapy will greatly help the elderly patients with community-acquired pneumonia.PurposeStudy on the influencing factors of mortality in elderly patients with community-acquired pneumonia(CAP),explore the early assessment method of the severity of CAP in the elderly patients.MethodsCollect the clinical dates of 187 elderly patients from January 2015-October 2016 in our hospital with CAP(?65Y),According to the prognosis,the patients were divided into death group(n=33,including patients who died during hospitalization and the patients who died within 30 days after give up treatment)and survival group(n = 154,including patients who take a favorable turn or were cured).Through the retrieval of relevant medical records,telephone inquiries and other research methods,get the basic information of the patients,vital signs,medical history,clinical manifestations,laboratory findings and imaging data,the data are summarized and analyzed by SPSS19.0.The chi-square test of four-fold table was used to analyze the influencing factors of death in elderly patients with CAP;multivariate logistic regression was used to screen the main influencing factors of mortality in elderly CAP patients;evaluate the effectiveness of early assessment of CAP severity in elderly patients by using the receiver operating characteristic curve.Results1.Advanced age(?80),hypotension at admission(systolic pressure<90mmHg or diastolic pressure<60mmHg),respiratory rate>30BPM,PCT>0.05ng/ml,CRP>10mg/l,DD>0.5mg/l,UREA>7mmol/l and underlying diseases indicate that the mortality of elderly patients with CAP was higher(P<0.05),ESR,WBC,hospitalization times of elderly CAP patients are not significantly related to mortality(P>0.05);2.CURB-65 score?3 CRP>10mg/l,DD>0.5mg/l and underlying diseases are the major contributing factors in mortality of elderly CAP patients,with the comprehensive consideration of CURB-65,DD,CRP and underlying diseases,we can improve the accuracy of the mortality prediction from 87.6%to 93.7%.Conclusion1.The age,admission blood pressure,respiratory rate,consciousness,UREA,PCT,CRP,DD and underlying diseases are the risk factors of mortality in elderly patients with CAP.ESR,WBC and hospitalization times do not have significant relevance with the mortality in elderly patients with CAP.2.CURB-65 score,CRP,DD and underlying diseases are the main influencing factors of the death of elderly CAP patients.The combination of the above four factors can improve the accuracy of mortality prediction in elderly CAP patients,thus it can be used as an effective method for assessing the condition of elderly patients with CAP.