YANG Xin , YANG Xue , BAI Min , WANG Dongguang , YAN Zhipeng , LIU Sitong , TONG Xiang , FAN Hong
  • Department of Respiratory Medicine and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
FAN Hong, Email: fanhongfan@qq.com
Community-acquired pneumonia; CURB-65 score; Inflammatory factor; Prognostic value; Diagnostic model
10.7507/1672-2531.201703061
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Objective  To evaluate the prognostic values of CURB-65 score and inflammatory factors in hospitalized patients with community-acquired pneumonia (CAP). Methods  A retrospective study was conducted in hospitalized adult CAP patients in West China Hospital between January 1st, and December 31th, 2013. Data of CURB-65 score and serum levels of inflammatory factors (WBC, ESR, PCT, CRP, IL-6 and ALB) on admission and clinical outcomes were collected. The associations between CURB-65 score, inflammatory factors and clinical outcomes were examined. Logistic regression analysis was performed to develop combined models to predict in-hospital death of CAP patients, and ROC analysis was conducted to measure and compare the prognostic values of CURB-65 score, inflammatory factors or combined models. Results  A total of 505 hospitalized CAP patients were included. 81 patients died during the hospitalization and the in-hospital mortality rate was 16.0%. Possible risk factors of in-hospital death included old age, male sex, hypertension, cardiovascular or cerebrovascular diseases, multi-lobular pneumonic infiltration, high risk scores, ICU admission, mechanical ventilation and severe pneumonia (all P values<0.05). Logistic regression analysis showed that CURB-65 score, ALB and IL-6 were the independent factors in predicting in-hospital death of CAP patients and the area under curve (AUC) of them while predicting in-hospital death were 0.75 (95%CI 0.69 to 0.81), 0.75 (95%CI 0.69 to 0.81) and 0.75 (95%CI 0.69 to 0.80), respectively. ROC analysis found that ALB and IL-6 could improve the AUC of CURB-65 score significantly while predicting the in-hospital death (P<0.05). When ALB and IL-6 were added to the CURB-65 score simultaneously, the AUC was improved to 0.84 (95%CI 0.80 to 0.87). When IL-6 or ALB was added to the CURB-65 score to form a new scale, the AUC of the new scale was significantly higher than that of the CURB-65 score in predicting in-hospital death (P<0.001). Conclusion  The prognostic values of CURB-65 score and inflammatory factors may be not ideal when they are used alone in hospitalized CAP patients. IL-6 and ALB may significantly improve the prognostic value of CURB-65 score in predicting in-hospital death.

Citation： YANG Xin, YANG Xue, BAI Min, WANG Dongguang, YAN Zhipeng, LIU Sitong, TONG Xiang, FAN Hong. Prognostic values of CURB-65 score and inflammatory factors for hospitalized community-acquired pneumonia patients. Chinese Journal of Evidence-Based Medicine, 2017, 17(6): 627-633. doi: 10.7507/1672-2531.201703061 Copy

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