4.5 Article

Evaluation of the factors affecting long-term mortality in geriatric patients followed up in intensive care unit due to hospital-acquired pneumonia

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MEDICINE
卷 101, 期 38, 页码 -

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MD.0000000000030645

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geriatric; inflammation-based biomarkers; intensive care unit; mortality; pneumonia

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This study aimed to investigate the role of acute-phase reactants and inflammation-based biomarkers in predicting 90-day mortality in patients aged over 65 years who were hospitalized in intensive care unit (ICU) due to hospital-acquired pneumonia (HAP). The results showed that serum white blood cell count (WBC) level can be used to predict long-term mortality and prognosis, with a high WBC value being significant in predicting 90-day independent mortality.
Aging is a normal physiological process involving changes in the respiratory system, thereby causing an increased incidence of pulmonary infections such as hospital-acquired pneumonia (HAP). The primary aim of this study was to investigate the role of acute-phase reactants and inflammation-based biomarkers in predicting 90-day mortality in patients aged over 65 years who were hospitalized in the intensive care unit (ICU) due to HAP. Clinical records of patients aged >= 65 years who were diagnosed as having HAP and were followed up in ICU were retrospectively evaluated. One hundred and fifteen ICU patients (67.8% male, mean age 76.81 +/- 7.480 years) were studied. Ninety-day mortality occurred in 43 (37.4%) patients. Red cell distribution (RDW, %), mean platelet volume (MPV, f/L), white blood cell count (WBC, 103/mu L), C-reactive protein (CRP, mg/L), and procalcitonin (PCT, ng/mL) median values were 18.2 (13.7-35.6), 7.42 (5.66-11.2), 14.3 (3.21-40), 9.58 (0.12-32), 0.41 (0.05-100) in the group with 90-day mortality. In the Receiver Operator Characteristics Curve analysis, a WBC value 18.2 x 103/mu L predicted 90-day independent mortality with a sensitivity of 90.70% and specificity of 31.94% (P = .029). The results indicated that serum WBC level can be used for predicting long-term mortality and prognosis in HAP patients aged over 65 years. High WBC value was statistically significant in predicting 90-day independent mortality (P < .05).

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