| Backgroundsevere community-acquired pneumonia is a frequently-occurring disease in people aged >60 years,with high mortality,and is the leading cause of death in the elderly.In recent years,the aging trend in my country has become increasingly intensified,and the number of patients with severe community-acquired pneumonia over the age of 60 has increased year by year,and its prevention and treatment has attracted much attention.Finding indicators closely related to the disease outcome of patients,exploring the prediction method of disease outcome,and accurately predicting the disease outcome of patients with severe communityacquired pneumonia in the elderly are of positive significance for guiding clinical formulation of individualized treatment plans and reducing mortality.ObjectiveThis study analyzed the correlation between the Pneumonia Severity Index(PSI)score,blood calcium concentration,serum cytokines and the disease outcome of severe community-acquired pneumonia in the elderly,and explored the value of each index in predicting the disease outcome of patients.To provide a reference for the scientific formulation of clinical treatment plans for patients with severe community-acquired pneumonia in the elderly.MethodsThis study was a retrospective study.A total of 176 patients with severe communityacquired pneumonia who were treated in our hospital and aged >60 years were selected from June 2019 to December 2021.The subjects were divided into survival group and death group according to the disease outcome.Retrospective analysis of PSI score,blood calcium concentration,serum cytokines [procalcitonin(PCT),C-reactive protein(CRP),white blood cell count(WBC)within 24 hours after admission in the two groups of patients were retrospectively analyzed.,apolipoprotein A1(Apo A1)] related data.The PSI score,blood calcium concentration,and serum cytokine levels were compared between the two groups,and Spearman rank correlation analysis was used to describe the relationship between the PSI score,blood calcium concentration,serum cytokines and the patient’s disease outcome;then ROC curve analysis was performed to compare PSI score,serum calcium concentration,and serum cytokines predict disease outcome in patients with severe community-acquired pneumonia in the elderly.Results(1)The PSI score of the patients in the death group was higher than that in the survival group within 24 hours of admission,and the difference was significant(P<0.05).(2)The blood calcium level in the death group within 24 hours of admission was lower than that in the survival group,and the incidence of hypocalcemia(44.44%)was higher than that in the survival group(7.38%),with significant differences(P<0.05).(3)PCT,CRP,WBC in the death group were higher than those in the survival group within 24 hours of admission,and Apo A1 was lower than that in the survival group,with a significant difference(P<0.05).(4)The results of Spearman correlation analysis showed that PSI score,PCT,CRP,WBC were positively correlated with disease outcome(survival,death)(P<0.05),and serum calcium,Apo A1 and disease outcome were positively correlated(P<0.05).There was a negative correlation(P<0.05).(5)The results of ROC curve analysis showed that the area under the curve(AUC)of each index predicting the patient’s disease outcome from high to low was PCT(0.897),PSI score(0.851),CRP(0.776),serum calcium(0.679),Apo A1(0.613),WBC(0.597).ConclusionPSI score,blood calcium concentration,and serum cytokines are all correlated with severe community-acquired pneumonia in the elderly,and can be used to predict the disease outcome of patients.The predictive value of each index is ranked from high to low.PCT,PSI score,CRP,serum calcium,Apo A1,WBC,PCT had the highest predictive value,and WBC had the worst predictive value.In clinical practice,the results can be predicted according to various indicators,and personalized treatment plans can be scientifically formulated for patients to reduce the risk of death and promote the recovery of the disease. |
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