Clinical Features Of Community Acquired Pneumonia In The Elderly And Non-elderly Groups In Our Hospital Were Retrospectively Analyzed

Objective : First,through retrospective analysis of the epidemiological characteristics of the patients with community-acquired pneumonia(CAP)admitted to the respiratory department of the Affiliated Hospital Of GuiLin Medical University(hereinafter referred to as "our hospital"),the general clinical characteristics of CAP patients in our hospital were understood.Second,according to China's diagnosis and treatment of adult CAP guide(2016 edition)(hereinafter referred to as "guidelines")in which of the following writing will CAP patients were divided into elderly group(?65)and < or non elderly group(<65),analysis and clinical features in elderly group and non elderly group patients admitted to hospital,peripheral blood(WBC,NEUT),calcitonin(PCT),C-reactive protein(CRP),the usage of antibiotics and disease outcomes,to explore the clinical characteristics,which provides objective basis for the diagnosis and treatment of our patients with CAP.Methods: 1.Object selection: 292 patients diagnosed as CAP were counted in the electronic medical record system of the department of respiratory medicine of our hospital from January 2014 to January 2017.Study group: CAP patients were divided into elderly groups and non elderly groups according to the guidelines.2.Diagnostic criteria: all patients were diagnosed according to the guidelines.3.Exclusion criteria: excluding HIV patients with poor immune function;Exclude patients who have been treated with anti-microbial therapy for more than two weeks;Patients without chest X-ray or CT lung;X-ray chest X-ray or pulmonary CT suggested that chest shadow was caused by pulmonary tuberculosis or other non-infectious diseases.Characteristic groups(such as pregnant women,psychosis,etc.);Other physiological or pathological factors that may affect the measurement of effect indicators.4.Collected data: statistics of the gender and age of hospitalized patients;Length of stay;Basic vital signs and first symptoms of patients on admission;Underlying disease;CURB-65 score;Laboratory test results;Application of antibiotics and outcome of the disease.5.Data processing: SPSS19.0 statistical analysis software was used to analyze by relevant statistical methods,and P<0.05 was considered statistically significant.Results: 1.Basic information: a total of 292 patients with CAP were counted,including 198 males(67.8%)and 94 females(32.2%).Age: 18 ~ 89 years old,mean(49.10 + 19.4)years old,<65 years old: 190,> 65 years old: 102;The length of stay ranged from 3 to 27 days,with the average length of stay(911 + 3.23),The median length of stay was 9 days in the elderly group and 8.5 days in the non-elderly group.The severity evaluation was performed on all CAP patients with CURB-65 score,including 146(50%)of low-risk patients,123(42.1%)of medium-risk patients,and 23(7.9%)of high-risk patients.Low-risk patients,139(95.2%)people treatment heal/effective,6(4.1%)treatment is invalid,1(0.7%)treatment is death,Medium-risk patients,114(92.7)people treatment heal/effective,8(6.5%)treatment is invalid,1(0.8%)treatment is death;High-risk patients,16(69.6%)people treatment heal/effective,5(21.7%)treatment is invalid,2(8.7%)treatment is death.;In the elderly group,11(10.8%)of the low-risk,78(76.5%)of the mudium-risk,13(12.7%)of the high-risk,In the non elderly group,135(71.1%)of the low-risk,45(23.6%)of the mudium-risk and 10(5.3%)of the high-risk.Most of the elderly people inthe medium or high risk,about 89.2%.Most of the non elderly people in the low or medium risk,about 94.7%.The rate of cure/effect was higher in the non-elderly group than in the elderly group.2.Statistical results showed that there was no statistically significant difference between low-risk patients and medium-risk patients in terms of treatment cure/effectiveness,ineffectiveness and mortality(P>0.05),while low-risk patients and high-risk patients were statistically significant in terms of treatment cure/effectiveness,inefficacy and mortality(P<0.05).Compared with non-elderly patients,elderly patients showed statistical significance in the combination of basic diseases,sputum culture,peripheral blood(WBC,NEUT)and PCT(P<0.05),while no statistical significance was found in the length of stay,CRP,or first-episode admission symptoms(P>0.05).Elderly group patients and patients with non elderly group in beta lactam + forests amide class number of antibiotic use in comparison with statistical significance(P < 0.05),the beta lactam,quinolone,beta lactam + large ring lactone class,beta lactam + quinolone,other class element using the number of birth is no statistical significance(P > 0.05).Conclusion: The patients with CAP in the department of respiratory medicine in our hospital are mainly non-elderly,and more male patients than female patients.According to CURB-65 score and guidelines,this survey shows that the hospitalization rate of CAP patients is higher than reported in the literature,and the invalid/mortality rate of patients in high-risk groups is high.It is suggested that clinicians in our hospital should strengthen the application of CURB-65 score and rationally use and allocate medical resources.The detection rate of pathogenic bacteria in sputum culture of CAP patients in our hospital was low.The sputum culture of CAP patients in our hospital was mainly dominated by klebsiella pneumoniae and streptococcus pneumoniae,and most of the candida albicans were probably colonized.The elderly patients were often associated with basic diseases.The infection status of elderly patients can not be determined by blood routine results alone.The PCT level was higher in the elderly group than in the non-elderly group.CRP can be used as an early diagnostic indicator of pulmonary infection.Respiratory physicians in our hospital have a consistency in the selection of experiential medication for patients with CAP,and the antibiotics of avian-lactamide and linkeramide are also safe and effective in the empirical treatment of elderly patients with CAP.