Prognostic value of qSOFA score and MNA score combined with serum procalcitonin level for elderly with severe community-acquired pneumonia
Received:August 19, 2020  
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DOI:10.11915/j.issn.1671-5403.2021.07.102
Key words:prognosis  severe community-acquired pneumonia  quick sequential organ failure assessment  mini-nutrtional assessment  procalcitonin This work was supported by the Project of Natural Science Foundation of Hainan Province
Author NameAffiliationE-mail
WU Yu-Dan Department of Respiratory and Critical Care Medicine, Haikou Hospital Affiliated to Central South University Xiangya School of Medicine, Haikou 570208, China 409270318@qq.com 
WU Mei-Jing Department of Respiratory and Critical Care Medicine, Haikou Hospital Affiliated to Central South University Xiangya School of Medicine, Haikou 570208, China 409270318@qq.com 
CHEN Ying-Shi Department of Respiratory and Critical Care Medicine, Haikou Hospital Affiliated to Central South University Xiangya School of Medicine, Haikou 570208, China 409270318@qq.com 
YOU Ying-Yu Department of Respiratory and Critical Care Medicine, Haikou Hospital Affiliated to Central South University Xiangya School of Medicine, Haikou 570208, China 409270318@qq.com 
FU Qiong-E Department of Respiratory and Critical Care Medicine, Haikou Hospital Affiliated to Central South University Xiangya School of Medicine, Haikou 570208, China 409270318@qq.com 
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Abstract:
      Objective To explore the predictive value of quick sequential organ failure assessment (qSOFA) score, mini-nutrtional assessment (MNA) score combined with serum procalcitonin (PCT) level in the prognosis of elderly patients with severe community-acquired pneumonia (SCAP). Methods Clinical data of 128 elderly SCAP patients admitted to our hospital from April 2018 to April 2020 were collected and retrospectively analyzed. After follow-up for 4 weeks, the patients were divided into survival group (n=110) and death group (n=18). The scores of qSOFA, MNA, pneumonia severity index (PSI) and Confusion-Uremia-Respiratory rate, Blood pressure and age ≥65 years (CURB-65), and the serum level of PCT were compared on the 1st, 3rd, and 7th days after admission between the 2 groups. Receiver operating characteristic (ROC) curve was plotted to analyze the area under the ROC curve (AUC) of qSOFA, MNA, CURB-65 and PSI scores and serum PCT level to analyze the risk factors for prognosis. SPSS statistics 20.0 was used for statistical analysis. Student′s t test or Chi-square test was employed for intergroup comparison on different data types. Results The qSOFA score and serum PCT on the 1st, 3rd, and 7th days were significantly lower in the survival group than the death group, and their average values at 1 week were obviously lower than those of the death group (P<0.05). The survival group had significantly higher MNA scores on the 1st, 3rd, and 7th days than the death group, so was the average MNA score at 1 week (P<0.05). The scores of CURB-65 and PSI in the survival group on the 1st, 3rd and 7th days were lower than those in the death group (P<0.05). The serum PCT level was positively correlated with qSOFA score (r=0.812, P<0.05), and negatively with MNA score (r=-0.785, P<0.05). The prognostic AUCs of qSOFA score, MNA score and serum PCT alone, and combined together were 0.712,0.705,0.722, and 0.862, respectively, and those of CURB-65 and PSI scores were 0.702 and 0.698, respectively. Cox regression analysis showed that length of hospital stay, respiratory acidosis, invasive mechanical ventilation, increased qSOFA score and serum PCT level, and decreased MNA score were risk factors affecting the prognosis of patients (P<0.05). Conclusion qSOFA and MNA scores combined with serum PCT level can be used to predict the prognosis of elderly SCAP patients.
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