论文摘要:
Objective:The study aimed to investigate the epidemiological characteristics and the independent prognostic risk factors for mortality in the patients with community-acquired pneumonia(CAP), to provide a better reference for prevention and treatment of CAP.
Methods:713 hospitalised patients with CAP in the Affiliated Hospital of Southwest Medical University were
prospectively studied from January 2015 to December 2016. Related clinical data were recorded and analyzed, thus to obtain the epidemiological characteristics and the independent prognostic risk factors of CAP.
Results:(1)The elderly CAP, often lacking the typical symptoms such as fever, cough, purulent sputum and chest pain observed in the non-elderly(
P<0.05), present with dyspnea, nausea and vomiting(
P<0.05). (2)When compared with the non-elderly, leukocyte count, the concentration of sensitive troponin I and d-dimer were higher in the elderly(
P<0.05). (3)Gram-negative bacilli dominate the pathogen of CAP. The main isolated bacilli including Klebsiella, Escherichia coli and Pseudomonas aeruginosa, all maintain a high susceptibility of 90% to carbopenems, amilacin and cepalosporins. (4)The mortality were 6.45%, 8.94% in the elderly and 3.01% in the non-elderly. (5)Univariate logistic regression anslysis and multivariate analysis showed, diabetes mellitus, renal insufficiency, hypoalbuminemia,mechanical ventilation and hyponatremia were the independent risk factors(
P<0.05).
Conclusions:(1)CAP were more common in the elderly in this research, presenting with less respiratory syndromes and more atypical clinical manifestation. (2) In this research, the predominantly pathogenic bacteria of CAP were Gram-negative bacilli, which maintain a high sensitivity to carbapenems, amilacin and beta-lactamase inhibitor antibiotics. (3)Diabetes mellitus, renal insufficiency, hypoalbuminemia, mechanical ventilation, hyponatremia were the independent prognostic risk factors for CAP in this research.