The significance of clinical pulmonary infection score and procalcitonin to assess the EICU elderly patients with severe community-acquired pneumonia

Objective:To investigate the significance of the clinical pulmonary infection score(CPIS)and procalcitonin(PCT)in EICU elderly patients with severe community-acquired pneumonia(SCAP).Method:Collect the clinical data of the elderly SCAP patients from January 2012 to December 2014 in emergency intensive care unit(EICU)of our hospital.The occurrence of acute respiratory distress syndrome(ARDS)within 1week was recorded and the patients were divided into ARDS group and non ARDS group according to the results.The patients' clinical outcome of 28 dwas followed up and then the patients were divided into survival group and death group.Compare the difference of CPIS and PCT between ARDS group and non ARDS group and between death group and survival group.Analyze the independent risk factors that can influence 28 dprognosis.Result:A total of 85 cases were included in the study.There were 36 cases coupled with ARDS within 1week,and 27 cases died within 28 days.The CPIS score in the ARDS group was significantly higher than that of non ARDS Group[(8.0±2.0)vs.(5.5±2.9),P0.05],and there was no statistical difference of PCT between the two groups(P0.05).The CPIS score and PCT of death group were significantly higher than that of the survival group respectively[(8.7±1.1)vs.(5.6±2.8),P0.05;4.8(3.0~10.1)ng/ml vs.0.9(0.4~2.1)ng/ml,P0.05].Comparing the area under the ROC curve of CPIS and APACHEⅡ,there was no statistical difference of predicting 28 doutcome between them.Both the CPIS score and PCT were the independent risk factor for the 28 day prognosis.Conclusion:The CPIS and PCT have great significance for the assessment of the EICU elderly patients with SCAP,identification of patients at risk,and judgment of prognosis.Both of them are independent risk factors for the 28 day prognosis.