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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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Objective: Community-acquired pneumonia (CAP) in older patients is a potentially life-threatening infection with a poor prognosis. Therefore, is important to predict the mortality rate of CAP for older patients. This study examined the effects of predictive increases on CAP mortality by adding a biomarker to known CAP severity prediction tools. Methods: A retrospective analysis of information was conducted on patients older than 65 years, who were treated with CAP in five emergency departments from October 2016 to February 2017. The primary outcome was the 28-day mortality. The following were calculated for each patient: qSOFA (quick Sequential Organ Failure Assessment), A-DROP (Age, Dehydration, Respiratory failure, Orientation, blood Pressure), CURB-65 (Confusion, Urea level, Respiratory rate, Blood pressure, age≥65 years), SMART-COP (Systolic blood pressure, Multilobar infiltrates, Albumin, Respiratory rate, Tachycardia, Confusion, Oxygen and pH), NLR (neutrophil:lymphocyte ratio), PLR (platelet:lymphocyte ratio), and CAR (high-sensitivity C-reactive protein:albumin ratio). The prognostic value for the 28-day mortality was determined by multivariate logistic regression analysis. Results: The 28-day mortality was 12.0% of 693 CAP patients. Multivariate logistic regression analysis showed that lactate (odds ratio [OR], 1.589; P<0.001) and CAR (OR, 1.208; P=0.006) were correlated with the 28-day mortality. NLR (OR, 1.00; P=0.983) and PLR (OR, 1.00; P=0.784) were not correlated. The area under curve (AUC) was significant as CAR 0.649, lactate 0.737, and SMART-COP 0.735 (P<0.001), and the AUC of lactate+SMART-COP increased significantly to 0.784 compared to SMART-COP (P=0.014). Conclusion: A combination of lactate and SMART-COP can be used as a tool to assess the severity of older hospitalized CAP patients who visited emergency departments.
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참고문헌 (40)
참고문헌 신청
Mion LC / 2001 / Establishing a case-finding and referral system for at-risk older individuals in the emergency department setting : the SIGNET model / J Am Geriatr Soc 49:1379~1386
Statistics Korea / 2018 / 2018 Statistics on the aged / Statistics Korea :2
Statistics Korea / 2017 / 2017 Annual report on the cause of death statistics :10~14
Niederman MS / 2001 / Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention / Am J Respir Crit Care Med 163:1730~1754
Fine MJ / 1990 / Prognosis of patients hospitalized with community-acquired pneumonia / Am J Med 88:1N~8N
Statistics Korea / 2018 / 2018 Statistics on the aged / Statistics Korea :2
Statistics Korea / 2017 / 2017 Annual report on the cause of death statistics :10~14
Niederman MS / 2001 / Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention / Am J Respir Crit Care Med 163:1730~1754
Fine MJ / 1990 / Prognosis of patients hospitalized with community-acquired pneumonia / Am J Med 88:1N~8N
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