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Prognostic factors for community-acquired pneumonia in middle-aged and elderly patients treated with integrated medicine

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Author:
No author available
Journal Title:
Journal of Traditional Chinese Medicine
Issue:
2
DOI:
No doi available
Key Word:
Rrognosis;Adverse outcome;Risk factor;Community-acquired pneumonia;Middle aged;Elderly;Chinese medicine

Abstract: [OBJECTIVE]:To identify prognostic factors in middle-aged and elderly patients with community-ac-quired pneumonia (CAP) who underwent integrated interventions involving traditional Chinese medicine (TCM) and modern medicine.[METHODS]:Patients aged ≥45 years and diagnosed with CAP were divided into a middle-aged cohort(45-59 years) and an elderly cohort (≥60 years),and clinical data comprising 75 predictor variables in seven classes were collected.After replacing missing data,calibrating multicenter differences and classifYing quantitative data,univariate and multivariate analysis were performed.[RESULTS]:On multivariate analysis,eight independent risk factors-respiration rate,C reactive protein (CRP),cost of hospitalization,anemia,gasping,confusion,moist rales and pneumonia severity index (PSI)-were correlated with the outcome "not cured" in the elderly cohort.Nine factors-neutro-phil percentage (Neu%),blood urea nitrogen(BUN),time to clinical stability,appetite,anemia,confusion,being retired or unemployed,Gram-negative bacterial infection and educational levelwere correlated with not cured in the middle-aged cohort.[CONCLUSION]:Independent predictive risk factors correlated with adverse outcomes in elderly patients were higher respiration rate,CRP≥four times the mean or median for the patient's center,cost of hospitalization>1 1,323 RMB and PSI>II,plus anemia,gasping,confusion and moist rales;those in middle-aged patients were higher Neu%,BUN≥mean or median,loss of appetite,anemia,confusion,being retired or unemployed and lower educational level.Gram-negative bacterial infection and time to clinical stability>9 days were protective factors.

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