Based on the clinical database of a Beijing Chaoyang Hospital Consortium Chaoyang Emergency Ward in Beijing Chaoyang Hospital, Capital Medical University, patients with pulmonary
infection were selected through the big data retrieval technology. According to the prognosis at the time of discharge, they were divided into death group and survival group. The general data of patients were collected, including gender, age, blood gas and laboratory indices. A computer language called Python was used to make batch calculations of key indicators that affect mortality in elderly patients with
pneumonia. Logistic regression analysis was used to analyze the relationship between laboratory indicators and patients' prognosis. Receiver operating characteristic curve (ROC curve) was drawn to analyze the predictive value of screening method for patients' prognosis.
RESULTS: A total of 265 patients were included in the study, 64 died and 201 survived. The data of the first detection indexes of each patient after admission were collected, and 23 key indicators with significant differences were selected from 472 indicators: blood routine indicators (n = 7), blood gas indicators (n = 3),
tumor markers indicators (n = 3), coagulation related indicators (n = 4), and nutrition and organ function indicators (n = 6). (1) The key indicators of blood gas in patients died of
pneumonia: Cl- was 97-111 mmol/L in 51.6% (33 cases) of patients,
lactic acid (Lac) was 0.5-2.5 mmol/L in 81.2% (52 cases) of patients, and H+ was 0-46 mmol/L in 87.5% (56 cases) of patients. (2) The key indicators of blood routine of patients died of
pneumonia:
hemoglobin count (Hb) of 46.9% (30 cases) patients was 80-109 g/L, the eosinophils proportions (EOS%) in 67.2% (43 cases) patients was 0.000-0.009, the lymphocytes proportions (LYM%) in 51.6% (33 cases) patients was 0.00-0.09, the red blood cell count (RBC) in 50.0% (32 cases) patients was (3.0-3.9)×1012/L, the white blood cell count (WBC) in 54.7% (35 cases) patients was (0.0-9.9)×109/L, and the red blood cell volume distribution width coefficientof variability (RDW-CV) in 48.4% (31 cases) patients was 10.0%-14.9%, serum
C-reactive protein (CRP) was 0.0-49.9 mg/L in 48.4% (31 cases) patients. (3) The key indicators of
tumor markers in patients died of
pneumonia: 76.6% (49 cases) of patients had negative free
prostate specific antigen/total
prostate specific antigen (FPSA/TPSA, the ratio was 0), 92.2% (59 cases) had
cytokeratin 19 fragment (CYFRA21-1) between 0.0-11.0 μg/L, and 75.0% (48 cases) had
carbohydrate antigen 125 (CA125) between 0-104 kU/L. (4) The key coagulation indexes of patients died of
pneumonia: 68.8% (44 cases) of patients had activated partial thromboplastin time (APTT) of 57-96 s, 73.4% (47 cases) of patients had
D-dimer of 0-6 mg/L, 93.8% (60 cases) of patients had thrombin time (TT) of 14-22 s, and 89.1% (57 cases) of patients had
adenosine diphosphate (
ADP) inhibition rate of 0%-53%. (5) Nutrition and organ function key indicatorsin patients died of
pneumonia: 92.2% (59 cases) of
brain natriuretic peptide (BNP) in patients with 0, 46.9% (30 cases) of patients had
prealbumin (PA) of 71-140 mg/L, 90.6% (58 cases) of the patients with
uric acid (UA) for 21-41 μmol/L, 75.0% (48 cases) of the patients with
albumin (Alb) to 10-20 g/L, 93.5% (60 cases) of patients had
albumin/
globulin ratio (A/G ratio) of 0-0.9, 84.4% (54 cases) of the patients with
lactate dehydrogenase (LDH) from 0-6.68 μmol/L×s-1×L-1. (6) Logistic regression analysis and ROC curve analysis: Logistic regression analysis showed that PA and Lac were the prognostic factors. PA could reduce the risk of death by 0.9%, Lac could increase the risk of death by 69.4%; the area under ROC curve (AUC) between laboratory indicators and the prediction effect of death prediction model for patients' prognosis was 0.80, which showed that the classification effect was better, and this study model could better predict the prognosis of elderly patients with
pneumonia.
CONCLUSIONS: