Investigating The Relationship Between Coagulation Function And The Severity Of Community-acquired Pneumonia In The Elderly

Objective: To investigate the influence of coagulation dysfunction on the severity and prognosis of elderly patients with community-acquired pneumonia(CAP).This study will provide a scientific basis for the early assessment of elderly patients with community-acquired pneumonia and the early intervention of coagulation abnormalities.Methods: The clinical data of 69 patients(male and female)over 65 years old with community-acquired pneumonia admitted to the Respiratory Department of the Fourth Affiliated Hospital of China Medical University from August 1,2019 to August 1,2020 were retrospectively analyzed.According to whether patients with combined coagulant function abnormality as community-acquired pneumonia group(group A,n = 29),community-acquired pneumonia combined coagulant function abnormality group(group B,n = 40),and the comparison between the two groups of patients with pneumonia severity,indicators,quality of life and prognosis of infection,judgment of coagulant function abnormality elderly community-acquired pneumonia condition.At the same time,the changes of plasma homocysteine(Hcy)level and thromboelastogram(TEG)were observed in elderly CAP patients(group C,n=26)with coagulation dysfunction mainly caused by elevated D-dimer.Results: There was no statistical difference in gender,age,smoking history and other basic clinical data between group A and group B(P>0.05).Compared with group A,group B had higher levels of inflammatory infection indicators CRP,PCT and N%(P<0.05),higher severity of pneumonia(PSI),more comorbidities,longer hospital stay,poorer disease outcome and quality of life(P<0.05).Spearman correlation analysis showed that D-dimer had a significant positive correlation with pneumonia severity(PSI)(r=0.740,P<0.05).Compared with group A,the plasma homocysteine level in group C was increased,and the R and K values in the thromboelastic graph were shortened,while the MA and CI values were increased,with statistical significance(P<0.05).Conclusions: The elderly patients with community-acquired pneumonia complicated with coagulation dysfunction have relatively severe disease,poor prognosis,and affect the quality of life to a certain extent.Among them,D-dimer was significantly correlated with the severity of pneumonia.Elder CAP patients with coagulation dysfunction,mainly with increased D-dimer,had changes in thrombus elastogram and increased plasma homocysteine level.