Clinical characteristics and prognosis of communityacquired pneumonia in autoimmune diseaseinduced immunocompromised host: A retrospective observational study
10.5847/wjem.j.1920-8642.2020.03.003
- Author:
Zhong-shu Kuang
- Publication Type:Journal Article
- Keywords:
Community-acquired pneumonia;
Immunocompromised hosts;
Autoimmune disease;
Prognostic marker
- From:
World Journal of Emergency Medicine
2020;11(3):145-151
- CountryChina
- Language:English
-
Abstract:
BACKGROUND: Community-acquired pneumonia (CAP) in autoimmune diseases (AID)-induced
immunocompromised host (ICH) had a high incidence and poor prognosis. However, only a few studies
had determined the clinical characteristics of these patients. Our study was to explore the characteristics
and predictors of mortality in CAP patients accompanied with AID-induced ICH.
METHODS: From 2013 to 2018, a total of 94 CAP patients accompanied with AID-induced
ICH, admitted to Emergency Department of Zhongshan Hospital, Fudan University, were enrolled in
this study. Clinical data and the risk regression estimates of repeated predictors were evaluated by
generalized estimating equations (GEEs) analysis. An open-cohort approach was used to classify
patient’s outcomes into the survival or non-survival group.
RESULTS: The hospital mortality of patients with CAP occurring in AID-induced ICH was
60.64%. No significant differences were found with respect to clinical symptoms and lung images
between survival and non-survival groups, while renal insufficiency and dysfunction of coagulation
had higher proportions in non-survival patients (P<0.05). Both noninvasive ventilation (NIV) and
invasive mechanical ventilation (IMV) were performed more frequently in non-survival group (P<
0.05). By the multivariate GEEs analysis, the repeated measured longitudinal indices of neutrophilto-
lymphocyte ratio (NLR) (odds ratio [OR]=1.055, 95% confidence interval [95%CI] 1.025–1.086),
lactate dehydrogenase (LDH) (OR=1.004, 95%CI 1.002–1.006) and serum creatinine (sCr)
(OR=1.018, 95%CI 1.008–1.028), were associated with a higher risk of mortality.
CONCLUSION: The CAP patients in AID-induced ICH had a high mortality. A signifi cant relationship
was demonstrated between the factors of NLR, LDH, sCr and mortality risk in these patients.