Prognostic factors for community-acquired pneumonia in middle-aged and elderly patients treated with integrated medicine  

作　　者：李建生 侯政昆 余学庆 李素云 孙子凯 张伟 贾新华 郑四平 王明航 王海峰 

机构地区：[1]Geriatric Department,Henan College of Traditional Chinese Medicine [2]Respiration Department,First Affiliated Hospital of Henan College of Traditional Chinese Medicine [3]Respiration Department,Jiangsu Province Hospital of Traditional Chinese Medicine [4]Respiration Department,Affiliated Hospital of Shandong University of Chinese Medicine [5]Respiration Department,First Affiliated Hospital of Changchun University of Chinese Medicine

出　　处：《Journal of Traditional Chinese Medicine》2012年第2期179-186,共8页中医杂志（英文版）

基　　金：Supported by the National Basic Research Program(973 Program) [No.2006CB504605];the Program for New Century Excellent Talents in Universities in Henan Province (No.2006HANCET-05)

摘　　要：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.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.

关 键 词：Rrognosis Adverse outcome Risk factor Community-acquired pneumonia Middle aged Elderly Chinese medicine 

分 类 号：R259[医药卫生—中西医结合]