Objective@#
Community -acquired
pneumonia (CAP) in older
patients is a potentially
life -threatening
infection with a poorprognosis. Therefore, is important to predict the mortality rate of CAP for older
patients . This study examined the effectsof predictive increases on CAP
mortality by adding a
biomarker to known CAP severity prediction tools. @*
Methods @#A retrospective
analysis of information was conducted on
patients older than 65 years,
who were treated withCAP in five
emergency departments from October 2016 to February 2017. The primary outcome was the 28-day
mortality .The following were calculated for each
patient qSOFA (quick Sequential Organ Failure Assessment), A-DROP (Age,
Dehydration ,
Respiratory failure ,
Orientation ,
blood Pressure ), CURB-65 (
Confusion ,
Urea level,
Respiratory rate , Bloodpressure, age≥65 years), SMART-COP (Systolic
blood pressure , Multilobar infiltrates,
Albumin ,
Respiratory rate ,
Tachycardia ,
Confusion ,
Oxygen and
pH ), NLR (
neutrophil lymphocyte ratio), PLR (
platelet lymphocyte ratio), and
CAR (high-
sensitivity C-reactive protein albumin ratio). The prognostic value for the 28-day
mortality was determined by multivariatelogistic
regression analysis . @*Results@#The 28-day
mortality was 12.0% of 693 CAP
patients . Multivariate
logistic regression analysis showed that
lactate (
odds ratio [OR], 1.589; P<0.001) and
CAR (OR, 1.208; P=0.006) were correlated with the 28-day
mortality . NLR(OR, 1.00; P=0.983) and PLR (OR, 1.00; P=0.784) were not correlated. The
area under curve (
AUC ) was significant asCAR 0.649,
lactate 0.737, and SMART-COP 0.735 (P<0.001), and the
AUC of
lactate +SMART-COP increased significantlyto 0.784 compared to SMART-COP (P=0.014). @*Conclusion@#A combination of
lactate and SMART-COP can be used as a tool to assess the severity of older hospitalizedCAP
patients who visited
emergency departments .