Prognostic factors for community-acquired pneumonia in middle-aged and elderly patients treated with integrated medicine |
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Authors: | LI Jian-sheng HOU Zheng-kun Geriatric Department Henan College of Traditional Chinese Medicine Zhengzhou Henan China YU Xue-Qing LI Su-yun WANG Ming-hang WANG Hai-feng |
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Affiliation: | ,Respiration Department,First Affiliated Hospital of Henan College of Traditional Chinese Medicine,Zhengzhou,Henan 450003,China SUN Zi-kai,Respiration Department,Jiangsu Province Hospital of Traditional Chinese Medicine,Nanjing,Jiangsu 210029,China ZHANG Wei,JIA Xin-hua,Respiration Department,Affiliated Hospital of Shandong University of Chinese Medicine,Jinan,Shandong 250011,China ZHENG Si-ping,Respiration Department,First Affiliated Hospital of Changchun University of Chinese Medicine,Jilin,Changchun 130021,China |
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Abstract: | OBJECTIVE:To identify prognostic factors in middle-aged and elderly patients with community-acquired pneumonia(CAP) who underwent integrated interventions involving traditional Chinese medicine(TCM) and modern medicine.METHODS:Patients aged ≥45 years and diagnosed with CAP were divided into a middle-aged cohort(45-59 years) and an elderly cohort(≥60 years),and clinical data comprising 75 predictor variables in seven classes were collected.After replacing missing data,calibrating multicenter differences and classifYing quantitative data,univariate and multivariate analysis were performed.RESULTS:On multivariate analysis,eight independent risk factors-respiration rate,C reactive protein(CRP),cost of hospitalization,anemia,gasping,confusion,moist rales and pneumonia severity index(PSI)-were correlated with the outcome "not cured" in the elderly cohort.Nine factors-neutrophil percentage(Neu%),blood urea nitrogen(BUN),time to clinical stability,appetite,anemia,confusion,being retired or unemployed,Gram-negative bacterial infection and educational level-were correlated with not cured in the middle-aged cohort.CONCLUSION:Independent predictive risk factors correlated with adverse outcomes in elderly patients were higher respiration rate,CRP≥four times the mean or median for the patient’s center,cost of hospitalization>11,323 RMB and PSI>II,plus anemia,gasping,confusion and moist rales;those in middle-aged patients were higher Neu%,BUN≥mean or median,loss of appetite,anemia,confusion,being retired or unemployed and lower educational level.Gram-negative bacterial infection and time to clinical stability>9 days were protective factors. |
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Keywords: | Rrognosis Adverse outcome Risk factor Community-acquired pneumonia Middle aged Elderly Chinese medicine |
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