Predictive value of neutrophil to lymphocyte ratio and CURB-65 score in elderly patients with community acquired pneumonia
10.3760/cma.j.issn.1671-0282.2021.10.014
- VernacularTitle:中性粒细胞/淋巴细胞比值与CURB-65评分在老年社区获得性肺炎预后评价中的作用
- Author:
Mingmei ZHONG
1
;
Kang XU
;
Zhen DING
;
Xiu LI
Author Information
1. 安徽医科大学第三附属医院（合肥市第一人民医院）呼吸与危重症医学科，合肥 230061
- Keywords:
Neutrophil to lymphocyte ratio;
CURB-65 score;
Aged;
Community acquired pneumonia;
Prognosis
- From:
Chinese Journal of Emergency Medicine
2021;30(10):1235-1239
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of neutrophil to lymphocyte ratio (NLR) and CURB-65 score in elderly patients with community acquired pneumonia (CAP).Methods:A total of 160 elderly CAP patients who were treated in Department of Respiratory and Critical Care Medicine of the Third Affiliated Hospital of Anhui Medical University between January 2019 and March 2020 were retrospectively analyzed. According to the 30-day survival, the patients were divided into the survival group ( n=127) and the death group ( n=33). The general clinical data, blood routine, liver and kidney function, blood sodium, coagulation function, C-reactive protein and procalcitonin were collected, and NLR and CURB-65 scores were calculated. Pass t-test or χ2 test was used to compare the differences of the above indexes between the two groups, and the high-risk factors of 30-day death in elderly CAP patients were screened by multivariate Logistic regression analysis; receiver operating characteristic curve (ROC) was drawn, and the predictive value of NLR and CURB-65 score on the risk of death was analyzed. Results:Compared with the survival group, the patients in the death group were older and had a higher proportion of neurological diseases and chest tightness symptoms ( P<0.05). The total number of lymphocytes, hemoglobin, and serum albumin were significantly decreased, and the total neutrophil count, blood urea nitrogen, D-dimer, NLR, C-reactive protein, procalcitonin and CURB-65 score were significantly increased in the death group (all P <0.05). Multivariate Logistic regression analysis showed that NLR and CURB-65 score were the independent risk factors of 30-day mortality in elderly CAP patients ( P<0.01). ROC survival curve showed that the area under the curve (AUC) of NLR was 0.823 [95% CI (0.747 ~ 0.900)], the cut-off value was 8.885, and the sensitivity and specificity of prognosis were 84.8% and 74.8%. The AUC of NLR combined with CURB-65 score was 0.872 [95% CI (0.801 ~ 0.942)], the cut-off value was 0.248, and the sensitivity and specificity of prognosis were 84.8% and 84.3%. The combination of the two indexes had better prognostic value than other independent evaluation indexes. Conclusions:NLR and CURB-65 scores are high risk factors of death in elderly CAP patients. The combination of the two indicators can better predict the risk of death.
