| Objective:Community-acquired pneumonia(CAP)is the main cause of high morbidity and mortality of respiratory system.In China,2.5 million people suffer from community-acquired pneumonia each year,and 120,000 of them die from this disease,ranking fifth among the leading causes of death in China.Clinical manifestations vary depending on the state of the pathogen and the host.This study mainly analyzes the personal information of CAP patients in Dalian,the incidence of common pathogens(sputum culture,sputum smear and serology as specimens),comorbidities and underlying diseases,to provide evidence for clinical diagnosis and prognosis of CAP patients in Dalian,shorten hospital stay,reduce the cost of public and private medical facilities,and improve treatment outcomes.Methods:Retrospective analysis of the age,gender,personal history,underlying diseases,complications,hospitalization day,hospitalization location,and different types of pathogenic infection and other related information of 1302 inpatients with first diagnosis of CAP in major hospitals in Dalian during the period from January 2016 to November 2018,they were divided into the elderly group(≥60 years old)and middle-aged group(45-59 years old)and the youth group(≤44 years old).They were grouped according to personal history such as gender,smoking history,incidence of common pathogens,underlying diseases and complications,Comparing the epidemiological characteristics and prognosis of CAP patients in different groups.Univariate/multivariate assessment of risk factors for improvement or deteriorated mortality,The related risk factors leading to prolonged hospitalization were obtained,and then the risk factors and independent risk factors affecting the prognosis of CAP were analyzed.Results:1.The general condition of the patient:In this study,1302 patients were enrolled,including 685 males and 617 females.The ratio of males to females was 1.1:1.There was no significant difference in the length of hospitalization between males and females.Meanwhile,there was no significant difference in age in hospitalization days(P<0.05).In terms of complications,respiratory failure,hyponatremia,hypokalemia and hypoproteinemia were the main complications.There was no significant difference in the length of hospitalization(P<0.05).2.The pathogen distribution of the patient’s infection:In this study,873 cases(67.1%)were positive for pathogens,among which bacterial infection was the most common,the most common one was sputum smear G~+cocci,512cases(58.6%);atypical pathogens with the highest detection rate of Mycoplasma pneumoniae,a total of 375 cases(43%).Followed by a mixed infection of 272 cases(20.9%),including 227 cases of G~+cocci infection,177 cases of G~-bacteria infection,136 cases of fungal infection,115 cases of Mycoplasma pneumoniae infection,Mixed infection with bacteria and fungi is common.83 cases(9.5%)were infected by virus.There were 231 cases of blood culture,193 cases of negative,38 cases of positive(16.5%)and G~+bacteria were detected.3.Prognosis of patients with CAP:In this study,1302 cases of CAP were analyzed,among which there were no deaths in middle-aged group;and 1 case in youth group,100 cases in elderly group.Univariate analysis showed that gender,age,hyponatremia,liver injury,hypoproteinemia,pleural effusion,respiratory failure,coronary heart disease,chronic obstructive pulmonary disease,diabetes,cerebrovascular disease and other factors had statistical significance in prognosis(P<0.05).4.Independent risk factors affecting the prognosis of CAP:According to binary logistic regression analysis,gastrointestinal bleeding,liver disease,hypoproteinemia,respiratory failure,and PSI score were independent risk factors for CAP death(P<0.05).Conclusions:1.The main pathogens of CAP in this study were G~+coccus(sputum smear)and Mycoplasma pneumoniae;2.Hypoproteinemia,respiratory failure,gastrointestinal bleeding,liver disease,and PSI score are independent risk factors for the prognosis of CAP in this study. |
