Clinical pulmonary infection score and procalcitonin for assessing the severity and prognosis of elderly patients with severe community acquired pneumonia

doi:10.3877/cma.j.issn.1674-1358.2018.01.012

Abstract

Abstract:

Objective

To investigate the value of clinical pulmonary infection score (CPIS) and procalcitonin (PCT) in the treatment of elderly patients with severe community-acquired pneumonia (SCAP).

Methods

Total of 60 elderly patients with SCAP in our hospital from February 2014 to February 2016 were collected. According to the prognosis, the patients were divided into survival group and death group. The difference of PCT, white blood cell (WBC), CPIS score between the two groups at the first day and 7th day after hospital admission were detected and their correlations with CPIS were analyzed.

Results

Compared with the first day, the levels of PCT and CPIS in the survival group were not significantly decreased at the 7th day after hospital admission (P all < 0.001), but the WBC was without significant change (P > 0.05). Compared with the first day, the levels of WBC, PCT and CPIS in the death group were not significantly changed (P all > 0.05). After 7 days treatment, there were significant difference in PCT and CPIS between the two groups (P all < 0.05). WBC, PCT, and CPIS in SCAP patients had no significant correlation with prognosis on the first day (P all > 0.05). After 7 days treatment, WBC was not associated with prognosis (P > 0.05), and PCT and CPIS were significantly correlated with the prognosis of SCAP (r = 0.44, P = 0.023; r = 0.58, P = 0.017).

Conclusions

PCT and CPIS were associated with severity and prognosis in elderly patients with SCAP in elderly patients. It could be used as a good biomarker for evaluating the prognosis of SCAP, which could be used for further treatment.

Key words: Clinical pulmonary injection score, Arocalcitonin, Severe community acquired pneumonia, White blood cell

Junjie Xie, Xun Yi, Fang Xu. Clinical pulmonary infection score and procalcitonin for assessing the severity and prognosis of elderly patients with severe community acquired pneumonia[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2018, 12(01): 61-64.

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References 25

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项目	0分	1分	2分
体温（℃）	36~38	38~39	< 36或> 39
WBC（× 10⁹）	4~11	11~17	< 4或> 17
分泌物	无痰或少许	中、大量非脓性	中、大量脓性
气体交换指数（PaO₂/FiO₂，kPa）	> 33	33	< 33
X线胸片浸润影	无	斑片状	融合片状
气管吸取物培养或痰培养	无致病菌生长	有致病菌生长	两次培养到同一种细菌或革兰染色与培养一致

项目	0分	1分	2分
体温（℃）	36~38	38~39	< 36或> 39
WBC（× 10⁹）	4~11	11~17	< 4或> 17
分泌物	无痰或少许	中、大量非脓性	中、大量脓性
气体交换指数（PaO₂/FiO₂，kPa）	> 33	33	< 33
X线胸片浸润影	无	斑片状	融合片状
气管吸取物培养或痰培养	无致病菌生长	有致病菌生长	两次培养到同一种细菌或革兰染色与培养一致

组别		WBC（× 10⁹）	PCT（ng/ml）	CPIS（分）
生存组
	第1天	9.03 ± 2.97	1.82 ± 0.35	6.99 ± 4.83
	第7天	8.73 ± 2.44	0.38 ± 0.17	3.07 ± 1.52
t值		0.427	20.270	4.240
P值		0.671	< 0.001	< 0.001
死亡组
	第1天	9.41 ± 3.02	1.87 ± 0.29	7.17 ± 3.74
	第7天	9.27 ± 2.94	1.92 ± 0.41^a	7.33 ± 4.91^a
t值		0.052	0.545	0.142
P值		0.958	0.587	0.887

组别		WBC（× 10⁹）	PCT（ng/ml）	CPIS（分）
生存组
	第1天	9.03 ± 2.97	1.82 ± 0.35	6.99 ± 4.83
	第7天	8.73 ± 2.44	0.38 ± 0.17	3.07 ± 1.52
t值		0.427	20.270	4.240
P值		0.671	< 0.001	< 0.001
死亡组
	第1天	9.41 ± 3.02	1.87 ± 0.29	7.17 ± 3.74
	第7天	9.27 ± 2.94	1.92 ± 0.41^a	7.33 ± 4.91^a
t值		0.052	0.545	0.142
P值		0.958	0.587	0.887

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