Clinical characteristics and prognostic factors of elderly and disabled patients with bacterial pneumonia and sepsis
Objective To explore the clinical characteristics and prognostic factors of elderly patients with bacterial pneumonia and sepsis.Methods A retrospective cohort study was conducted to collect the basic characteristics and clinical features of the elderly(age ≥80 years old)disabled patients with bacterial pneu-monia and sepsis.The survival status of the patients was observed 30 days after admission,and the differences of clinical characteristics of the patients in different states were compared.COX regression model was used to analyze the influencing factors of patients'prognosis.Results A total of 63 patients were included,with an average age of(86.84±4.83)years,including 49 cases in the survival group and 14 cases in the death group.Compared with the survival group,the death group had higher sequential organ failure assessment(SOFA)score,△ SOFA score,and acute physiological and chronic health evaluation(APACHE Ⅱ)score at admission,lower oxygenation index,serum albumin,and endogenous creatinine clearance before and after treatment,higher D-dimer levels before and after treatment,and higher proportions of intravenous crystalloid fluid sup-plementation,combined use of 20％human serum albumin injection,and use of vasoactive drugs during fluid resuscitation,with statistically significant differences(P＜0.05).COX regression analysis showed that A-PACHE Ⅱ score at admission(HR=1.268,95％CI:1.093-1.471,P=0.002),urea/creatinine within 24 hours after treatment(HR=1.070,95％CI:1.015-1.128,P=0.011),the combination of 20％human albu-min injection during fluid resuscitation(HR=0.077,95％CI:0.010-0.624,P=0.016)were influential fac-tors in the survival of patients at 30 days.Conclusion APACHE Ⅱ score at admission and urea/creatinine within 24 hours after treatment are valuable for predicting high risk of death in elderly and disabled patients with bacterial pneumonia and sepsis.Combined treatment with 20％human blood albumin injection can im-prove prognosis.
万方数据
维普
