单位：[1]Department of Respiratory Medicine, Qingdao Municipal Hospital Group,Jiaozhou Road, Qingdao City 266011, Shandong Province, China[2]Department of Infectious Disease, Beijing Jishuitan Hospital, Xinjiekou EastStreet, Xi-cheng District, Beijing 100044, China[3]National Clinical ResearchCenter of Respiratory Diseases,Center for Respiratory Diseases, China-JapanFriendship Hospital, Beijing, China[4]Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Yinghuayuan East Street,Chao-yang District, Beijing 100020, China[5]Department of RespiratoryMedicine, Yan’an Hospital Affiliated to Kunming Medical University, RenminEast Road, Kunming City 652199, Yunnan Province, China[6]Department ofRespiratory Medicine, Beijing Huimin Hospital, Youanmen Street, WestDistrict, Beijing 100054, China[7]Department of Respiratory Medicine, LinziDistrict People’s Hospital, Huangong Road, Zibo City 255000, ShandongProvince, China[8]Department of Respiratory Medicine, Beijing Luhe Hospital,Capital Medical University, Xinhua South Road, Tongzhou District, Beijing101149, China[9]Department of Pulmonary and Critical Care Medicine,Weifang No.2People’s Hospital, Yuanxiao Street, Weifang City 261599,Shandong Province, China[10]Department of Respiratory Medicine, ShandongUniversity Affiliated Qilu Hospital (Qingdao), Hefei Road, Qingdao City266035, Shandong Province, China[11]Department of Respiratory Medicine,The 2nd Hospital of Beijing Corps, Chinese Armed Police Forces, YuetanNorth Street, Xi-cheng District, Beijing 100044, China[12]Department ofInfectious Disease, Qingdao University Medical College AffiliatedYantaiyuhuangding Hospital, Yudong Road, Yantai City 100191, ShandongProvince, China[13]Department of Respiratory Medicine, Rizhao ChineseMedical Hospital Affiliated to Shandong Chinese Medical University, WanghaiRoad, Rizhao City 276800, Shandong Province, China[14]Department ofRespiratory Medicine, Beijing Hospital of Traditional Chinese MedicineAffiliated to Capital Medical University, Meishuguan Street, East District,Beijing 100010, China[15]Department of Occupational Medicine andToxicology, Beijing Chao-Yang Hospital, Capital Medical University, GongtiSouth Road, Chao-yang District, Beijing 100020, China北京朝阳医院
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/FiO(2) < 200 mmHg, sodium < 130 mmol/L, healthcare-associated pneumonia, white blood cells > 10,000/mm(3), 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.
基金：
National Science Grant for Distinguished Young Scholars [81425001/H0104]; National Key Technology Support Program from Ministry of Science and Technology [2015BAI12B11]; Beijing Science and Technology Project [D151100002115004]
第一作者单位：[1]Department of Respiratory Medicine, Qingdao Municipal Hospital Group,Jiaozhou Road, Qingdao City 266011, Shandong Province, China
通讯作者：
推荐引用方式(GB/T 7714)：
Han Xiudi,Liu Xuedong,Chen Liang,et al.Disease burden and prognostic factors for clinical failure in elderly community acquired pneumonia patients[J].BMC INFECTIOUS DISEASES.2020,20(1):doi:10.1186/s12879-020-05362-3.
APA：
Han, Xiudi,Liu, Xuedong,Chen, Liang,Wang, Yimin,Li, Hui...&Cao, Bin.(2020).Disease burden and prognostic factors for clinical failure in elderly community acquired pneumonia patients.BMC INFECTIOUS DISEASES,20,(1)
MLA：
Han, Xiudi,et al."Disease burden and prognostic factors for clinical failure in elderly community acquired pneumonia patients".BMC INFECTIOUS DISEASES 20..1(2020)
