A Study About The Prognostic Value Of Enhanced CURB Scores In The Different Age Section Elderly Community Acquired Pneumonia

ObjectiveTo collect,count,and analyze clinical data of elderly patients with community-acquired pneumonia,to compare the differences in mortality between patients in different risk strata of the enhanced CURB score and the CURB-65 score,and to compare the predictive efficacy of the two scoring systems on the prognosis of elderly patients with community-acquired pneumonia in different age segments.MethodsA total of 281 elderly CAP patients admitted to the respiratory medicine department of our hospital from January 2020 to December 2020 were collected,and relevant clinical data were collected to calculate the intensive CURB score and CURB score score for each patient.Patients with 0-2 points in the CURB score were classified as low-risk group,and those with ≥ 3 points were classified as high-risk group.Those with ≤12 points were classified as low-risk group and those with >12 points were classified as high-risk group in the intensive CURB score criteria.At the same time the patients were divided into low age group(65-84 years)and high age group(≥85 years)according to the age of the patients,and the clinical data of the patients were analyzed,and the CURB-65 score and the intensive CURB score of each patient were counted,and the 30-d prognosis(morbidity and mortality rate)was used as the clinical observation endpoint in the CURB-65 score and the intensive CURB score,respectively,to compare the mortality rates between patients in different risk strata of the two scoring systems.The differences in mortality between patients in different risk strata of the two scoring systems were compared,The predictive value of the two scoring systems for the prognosis of elderly CAP patients without age segmentation was analyzed by plotting subject operating characteristic(ROC)curves and comparing the area under the curve AUC values.ResultsA total of 281 patients were collected in the study,with an overall mortality rate of 21.7%.The mortality rate was 13.2% in the low-risk group and 42.9% in the high-risk group for the intensive CURB score in the low age group;12.5% in the low-risk group and 52.2% in the high-risk group for the intensive CURB score in the high age group;13.2% in the low-risk group and 57.1% in the high-risk group for the CURB-65 score in the low age group;and 57.1% in the low-risk group and 70.6% in the high-risk group;and 26.2% in the low-risk group and 70.6% in the high-risk group with CURB-65 score.By comparing the mortality rate of patients between the two groups,the mortality rate was significantly higher in the high age group than in the low age group,with a significantly higher mortality rate as the intensive CURB score and the risk stratification of the CURB score increased,with a smaller difference between the mortality rate in the low and high risk group with the intensive CURB score and the low and high risk group with the CURB score(13.2% vs.13.2% and42.9% vs.57.1%,respectively),the mortality rate in the low and high risk group with CURB score was significantly higher than that in the low and high risk group with intensive CURB score(12.5% vs.26.2% and 52.2% vs.70.6%,respectively)in the high age group;the AUC for predicting death in the low age group with intensive CURB score and CURB-65 score were 0.731(p<0.05)(95% CI: 0.642 to 0.819),respectively 0.665(p<0.05)(95% CI: 0.556 to 0.774),and the AUC for predicting death by intensive CURB score and CURB-65 score in the high age group were 0.772(p<0.05)(95% CI: 0.660 to 0.885)and 0.714(p < 0.05)(95% CI: 0.591 to 0.837),respectively,All were statistically significant.ConclusionsThe predictive efficacy of the enhanced CURB score and CURB score for mortality in elderly CAP patients was better in the higher age group than in the lower age group,and the prognostic efficacy of the enhanced CURB score was higher than that of the CURB score for mortality in elderly patients in both the lower and higher age groups;mortality was significantly higher in the higher age group than in the lower age group,and mortality in patients increased significantly with increasing hazard stratification of the enhanced CURB score and CURB score;both scoring systems showed better prognostic predictive value for the prognosis of elderly patients.