| Objective1.Assess the early diagnosis value of PCT and NLR in elderly community-acquired pneumonia.2.Analyze the factors affecting the early diagnosis and prognosis related to elderly community-acquired pneumonia.MethodA retrospective study was conducted using a case-control method with elderly CAP patients admitted to the ward of the Department of Respiratory and Critical Care Medicine I of Shaanxi Provincial People’s Hospital from January 2018 to June 2020 and elderly healthy individuals who underwent physical examination at our medical examination center during the same period.According to the inclusion and exclusion criteria,a total of75 patients were included in the case group and 150 healthy individuals were included in the control group.General information and case data were collected.Excel sheet was used to enter the information of patients in the case group and control group and to create a database.Data analysis was performed using SPSS 25.0.The counting data were described using rate(n%),and theX~2test was used for comparison between groups.Normality test was performed using K-S test,and measures that conformed to normal distribution were expressed as mean±standard deviation((?)±s),and t-test was used for comparison between groups,and measures that did not conform to normal distribution were expressed as median and interquartile range(M,IQR),and Mann-Whitney U test was used for comparison between groups.Logistic regression model was used to predict the risk factors associated with the occurrence and 30-day death of elderly CAP.Model validity was assessed using the Hosmer-Lemesshow goodness-of-fit test.The sensitivity,specificity and area under the curve(AUC)of the laboratory indicators associated with the occurrence of community-acquired pneumonia in elderly patients were calculated using the receiver operating characteristic curve(ROC)and the Jorden index to analyze the effect of the corresponding indicators on the diagnostic value of CAP in patients aged 80years and older.Result1.A total of 124 males and 101 females were included,with a male to female sex ratio of1.23:1,mean age(84.67±2.93)years,smokers totaled 85 cases,accounting for 37.78%,hypertensive patients totaled 140 cases,accounting for 62.22%,diabetic patients totaled129 cases,accounting for 57.33%,cardiovascular disease patients totaled 161 cases,accounting for 71.56%,cerebrovascular disease in 72 cases,accounting for 32.00%,COPD patients totaled 63 cases,accounting for 28.00%,chronic liver disease patients totaled 52 cases,accounting for 23.11%,chronic kidney disease patients totaled 43 cases,accounting for 19.11%,and hypoproteinemia patients totaled 68 cases,accounting for30.22%.2.The gender and age composition of patients in the two groups,the results were not different(P>0.05).Smoking rate,hypertension,diabetes mellitus,cardiovascular disease,cerebrovascular disease,COPD,chronic liver disease,chronic kidney disease,and hypoproteinemia,the results were different between the two groups(P<0.05).3.The results of laboratory indicators:PCT,NC,LC,and NLR were different in the case group compared to the control group(P<0.05).4.Logistic regression analysis showed that smoking was an independent risk factor for the occurrence of CAP in elderly(OR=0.35,95%CI 0.19～0.64).5.The results of the case group showed a 30-day mortality rate of 22.67%.There were no differences between the two groups in terms of gender composition,age,and smoking rate(P≥0.05),and the results were different in terms of hypertension,diabetes,cardiovascular disease,cerebrovascular disease,COPD,chronic liver disease,chronic kidney disease,hypoproteinemia,and LOS(P<0.05).The results of NC,LC,NLR,and PCT were not different between the two groups of patients(P>0.05).6.Cerebrovascular disease was shown to be an independent risk factor for 30-day mortality in elderly CAP patients by multifactorial analysis(OR=0.01,95%CI 0.00～0.08).7.The ROC curves showed that the AUROC of PCT was 0.83(95%CI 0.76-0.90),with cut-off of 0.07ng/ml,sensitivity 0.64,1-specificity 0.02,and Yordon index 0.62;the AUROC of NLR was 0.82(95%CI 0.74-0.89),with cut-off of 5.22,sensitivity 0.67,1-specificity 0.04,and Yordon index 0.63;the AUROC of PCT+NLR was 0.89(95%CI0.84-0.95),sensitivity 0.81,1-specificity 0.07,and Yordon index 0.75.Conclusion1.PCT,NLR,and PCT+NLR all have high value in the early diagnosis of CAP in advanced age,with PCT combined with NLR having the highest diagnostic value.2.Smoking,hypertension,diabetes mellitus,cardiovascular disease,cerebrovascular disease,COPD,chronic liver disease,chronic kidney disease,and hypoproteinemia are risk factors for the development of CAP in elderly person,with smoking being an independent risk factor for the development of CAP in elderly people.3.Hypertension,diabetes mellitus,cardiovascular disease,cerebrovascular disease,COPD,chronic liver disease,chronic kidney disease,hypoproteinemia,and length of hospitalization are risk factors for 30-day mortality in elderly CAP patients,with cerebrovascular disease being an independent risk factor for 30-day mortality in elderly CAP patients. |
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