Risk factors analysis on the elderly with systemic inflammatory response syndrome caused by pulmonary disease

Objective To explore the risk factors on the elderly with systemic inflammatory response syndrome (SIRS) caused by pulmonary disease. Methods The clinical data of 50 elderly patients with SIRS caused by pulmonary disease in intensive care medicine (ICU) department of the first hospital affiliated to Zhejiang university medical college from September 2009 to December 2010 were retrospectively analyzed. All the patients were divided into death group (32 cases) and survival group (18 cases) on the basis of the prognosis. The levels of cholinesterase (ChE), albumin (ALB), D-dimer, lactic acid and C-reactive protein(CRP) were detected, and the acute physiology and chronic health evaluation (APACHE)Ⅱand GCS scores were finished in the first 24 h in the ICU. Results The age, and the levels of D-dimer, CRP, ChE between the death group and the survival group showed significant difference (all P0.05), except the levels of lactic acid, D-dimer, ALB and the APACHEⅡscores (all P0.05). The results of multiple factors regression analysis showed that ChE was the only independent risk factor on prognosis in gerontal patients with SIRS (β=-0.016, P=0.040). The receiver operating characteristic curve (ROC) of ChE showed the area under curve was 0.839, S.E.=0.057,P=0.000, and the tangent point (ChE=98.5 U/L, sensitivity=88.9, 1-specificity=0.25) could be a diagnosis point. Conclusion ChE maybe played an important role in the elderly patients with SIRS, and could be a predictive index for the SIRS prognosis.