Clinical characteristics and prognosis of community-acquired pneumonia in autoimmune disease-induced  

作　　者：Zhong-shu Kuang Yi-lin Yang Wei Wei Jian-li Wang Xiang-yu Long Ke-yong Li Chao-yang Tong Zhan Sun Zhen-ju Song 

机构地区：[1]Department of Emergency Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China [2]Department of Pharmacology,University of Virginia School of Medicine Charlottesville,Virginia,USA

出　　处：《World Journal of Emergency Medicine》2020年第3期145-151,共7页世界急诊医学杂志（英文）

基　　金：the Shanghai Traditional Medicine Development Project (ZY3-CCCX3-3018, ZHYY- ZXYJH-201615);the National Natural Science Foundation of China (81471840, 81171837);the Zhongshan Hospital Distinguished Young Scholars and the Shanghai Municipal Planning Commission of science and Research Fund (20134Y023);Key Project of Shanghai Municipal Health Bureau (2016ZB0202).

摘　　要：BACKGROUND:Community-acquired pneumonia(CAP)in autoimmune diseases(AID)-induced immunocompromised host(ICH)had a high incidence and poor prognosis.However,only a few studies had determined the clinical characteristics of these patients.Our study was to explore the characteristics and predictors of mortality in CAP patients accompanied with AID-induced ICH.METHODS:From 2013 to 2018,a total of 94 CAP patients accompanied with AID-induced ICH,admitted to Emergency Department of Zhongshan Hospital,Fudan University,were enrolled in this study.Clinical data and the risk regression estimates of repeated predictors were evaluated by generalized estimating equations(GEEs)analysis.An open-cohort approach was used to classify patient's outcomes into the survival or non-survival group.RESULTS:The hospital mortality of patients with CAP occurring in AID-induced ICH was 60.64%.No significant differences were found with respect to clinical symptoms and lung images between survival and non-survival groups,while renal insufficiency and dysfunction of coagulation had higher proportions in non-survival patients(P<0.05).Both noninvasive ventilation(NIV)and invasive mechanical ventilation(IMV)were performed more frequently in non-survival group(P<0.05).By the multivariate GEEs analysis,the repeated measured longitudinal indices of neutrophilto-lymphocyte ratio(NLR)(odds ratio[OR]=1.055,95%confidence interval[95%CI]1.025–1.086),lactate dehydrogenase(LDH)(OR=1.004,95%CI 1.002–1.006)and serum creatinine(s Cr)(OR=1.018,95%CI 1.008–1.028),were associated with a higher risk of mortality.CONCLUSION:The CAP patients in AID-induced ICH had a high mortality.A significant relationship was demonstrated between the factors of NLR,LDH,s Cr and mortality risk in these patients.

关 键 词：COMMUNITY-ACQUIRED PNEUMONIA IMMUNOCOMPROMISED HOSTS AUTOIMMUNE disease PROGNOSTIC marker 

分 类 号：R593.2[医药卫生—内科学] R563.1[医药卫生—临床医学]