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

Abstract

OBJECTIVE:

To identify prognostic factors in middle-aged and elderly patients with community-acquired pneumonia (CAP) who underwent integrated interventions involving traditional Chinese medicine (TCM) and modern medicine.

METHODS:

Patients aged > or =45 years and diagnosed with CAP were divided into a middle-aged cohort (45-59 years) and an elderly cohort (> or =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--neutrophil percentage (Neu%), blood urea nitrogen (BUN), time to clinical stability, appetite, anemia, confusion, being retired or unemployed, Gram-negative bacterial infection and educational level were 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 > or = four times the mean or median for the patient's center, cost of hospitalization >11,323 RMB and PSI >11, plus anemia, gasping, confusion and moist rales; those in middle-aged patients were higher Neu%, BUN > or = 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.

• Authors: Jian-sheng Li, Zheng-kun Hou, Xue-qing Yu, Su-Yun Li, Zi-kai Sun, Wei Zhang, Xin-hua Jia, Si-ping Zheng, Ming-hang Wang, Hai-feng Wang
• Journal: Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan (J Tradit Chin Med) Vol. 32 Issue 2 Pg. 179-86 (Jun 2012) ISSN: 0255-2922 [Print] China
• PMID: 22876440 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Age Factors
• Aged
• Blood Urea Nitrogen
• Community-Acquired Infections (drug therapy, mortality)
• Female
• Humans
• Male
• Medicine, Chinese Traditional
• Middle Aged
• Multivariate Analysis
• Pneumonia (drug therapy, mortality)
• Prognosis
• Risk Factors