Disease burden and prognostic factors for clinical failure in elderly community acquired pneumonia patients
- PDF / 755,209 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 6 Downloads / 157 Views
RESEARCH ARTICLE
Open Access
Disease burden and prognostic factors for clinical failure in elderly community acquired pneumonia patients Xiudi Han1*, Xuedong Liu1, Liang Chen2, Yimin Wang3,4, Hui Li3,4, Fei Zhou3,4, Xiqian Xing5, Chunxiao Zhang6, Lijun Suo7, Jinxiang Wang8, Guohua Yu9, Guangqiang Wang10, Xuexin Yao11, Hongxia Yu12, Lei Wang13, Meng Liu14, Chunxue Xue8, Bo Liu7, Xiaoli Zhu15, Yanli Li3,4, Ying Xiao3,4, Xiaojing Cui3,4, Lijuan Li3,4, Bin Cao3,4 and for the CAP-China network
Abstract Background: The study was to evaluate initial antimicrobial regimen and clinical outcomes and to explore risk factors for clinical failure (CF) in elderly patients with community-acquired pneumonia (CAP). Methods: 3011 hospitalized elderly patients were enrolled from 13 national teaching hospitals between January 1, 2014 and December 31, 2014 initiated by the CAP-China network. Risk factors for CF were screened by multivariable logistic regression analysis. Results: The incidence of CF in elderly CAP patients was 13.1%. CF patients were older, longer hospital stays and higher treatment costs than clinical success (CS) patients. The CF patients were more prone to present hyperglycemia, hyponatremia, hypoproteinemia, pleural effusion, respiratory failure and cardiovascular events. Inappropriate initial antimicrobial regimens in CF group were significantly higher than CS group. Undertreatment, CURB-65, PH < 7.3, PaO2/FiO2 < 200 mmHg, sodium < 130 mmol/L, healthcare-associated pneumonia, white blood cells > 10,000/mm3, pleural effusion and congestive heart failure were independent risk factors for CF in multivariable logistic regression analysis. Male and bronchiectasis were protective factors. Conclusions: Discordant therapy was a cause of CF. Early accurate detection and management of prevention to potential causes is likely to improve clinical outcomes in elderly patients CAP. Trial registration: A Retrospective Study on Hospitalized Patients With Community-acquired Pneumonia in China (CAP-China) (RSCAP-China), NCT02489578. Registered 16 March 2015, https://register.clinicaltrials.gov/prs/app/ action/SelectProtocol?sid=S0005E5S&selectaction=Edit&uid=U0000GWC&ts=2&cx=1bnotb Keywords: Community-acquired pneumonia, Clinical failure, Treatment pattern, Elderly
* Correspondence: [email protected] 1 Department of Respiratory Medicine, Qingdao Municipal Hospital Group, Jiaozhou Road, Qingdao City 266011, Shandong Province, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line
Data Loading...
