Prognosis of hospitalized patients with community-acquired pneumonia
Prognosis of hospitalized patients with community-acquired pneumonia
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DOI：
10.1016/j.rppnen.2017.07.010
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发表时间：
2018-05-01
期刊：
影响因子：
11.7
通讯作者：
Edis, E. Cakir
中科院分区：
文献类型：
--
作者：
Akyil, F. Tokgoz;Yalcinsoy, M.;Edis, E. Cakir
前言：近年来，社区获得性肺炎（CAP）患者的长期预后引起了越来越多的关注。本研究的目的是调查CAP住院患者的短期和长期结局，并确定与mortality.Patients和Methods相关的预测因素：本研究设计为一项回顾性、多中心、观察性研究。纳入了2011年至2013年土耳其胸科学会肺炎数据库中记录的CAP住院患者。短期死亡率定义为30天死亡率，长期死亡率根据存活30天的患者进行评估。结果：该研究包括785例患者，其中68%为男性，平均年龄为67 +/- 16（18-92）。中位随访时间为61.2 +/- 11.8（37-90）个月。30天死亡率为9.2%，存活30天的患者中位生存期为62.8 +/- 4.4个月。多因素分析显示，高龄、无发热、Charlson合并症评分高、血尿素氮（BUN）/白蛋白比值高和丙氨酸氨基转移酶（ALT）水平低是长期病死率的预测因素。Charlson评分和无发热是长期生存率降低的潜在指标。作为新参数，基线BUN/白蛋白比值和ALT水平与晚期死亡率显著相关。对这些亚组患者需要进一步干预和密切监测。(C)2017年，葡萄牙石油公司。出版社：Elsevier Espana，S.L.U.
Introduction: The long-term prognosis of patients with community-acquired pneumonia (CAP) has attracted increasing interest in recent years. The objective of the present study is to investigate the short and long-term outcomes in hospitalized patients with CAP and to identify the predictive factors associated with mortality.Patients and methods: The study was designed as a retrospective, multicenter, observational study. Hospitalized patients with CAP, as recorded in the pneumonia database of the Turkish Thoracic Society between 2011 and 2013, were included. Short-term mortality was defined as 30-day mortality and long-term mortality was assessed from those who survived 30 days. Predictive factors for short- and long-term mortality were analyzed.Results: The study included 785 patients, 68% of whom were male and the mean age was 67 +/- 16 (18-92). The median duration of follow-up was 61.2 +/- 11.8 (37-90) months. Thirty-day mortality was 9.2% and the median survival of patients surviving 30 days was 62.8 +/- 4.4 months. Multivariate analysis revealed that advanced age, the absence of fever, a higher Charlson comorbidity score, higher blood urea nitrogen (BUN)/albumin ratios and lower alanine aminotransferase (ALT) levels were all predictors of long-term mortality.Conclusion: Long-term mortality following hospitalization for CAP is high. Charlson score and lack of fever are potential indicators for decreased long-term survival. As novel parameters, baseline BUN/albumin ratios and ALT levels are significantly associated with late mortality. Further interventions and closer monitoring are necessary for such subgroups of patients. (C) 2017 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espana, S.L.U.