【Abstract】Objective To study the quality of life (QoL) at discharge in elderly patients with pulmonary infection in emergency department. Methods A total of 310 elderly patients with community-acquired pneumonia (CAP) admitted in emergency ward of our hospital from January 2022 to January 2023 were recruited in this study. The mortality of the patients during hospitalization was counted, and the QoL of survivors was investigated by 36-item short-form health survey (SF-36) at discharge. According to the SF-36 scale score, the elderly emergency CAP survivors were divided into high-level group (the score ≥ the average score, n=126) and low-level group (the score < the average score, n=134). All these patients were followed up for one year after discharge, and the readmission rate and mortality due to CAP were counted. SPSS statistics 22.0 was used for statistical analysis. Data comparison between two groups was performed by using t test, χ² test or Fisher′s exact probability test depending on data type. Binary logistic regression model was adopted to analyze the related factors affecting the QoL at discharge in the elderly CAP survivors in emergency department. Results Among the 310 subjected patients, 43 (13.87%) died during hospitalization, and 267 (86.13%) survived at discharge. There were 260 valid questionnaires collected in the 267 survivors, with an effective recovery rate of 97.39%. The total score of the SF-36 scale of the enrolled subjects was (573.63±65.69) points. The score of each dimension and the total score of the SF-36 scale at discharge were significantly lower in the elderly emergency CAP survivors than the domestic norm (P<0.05). Taking the QoL of elderly emergency CAP survivors at discharge as the dependent variable, binary logistic regression analysis found that length of hospital stay ≥14 d (OR=2.201,95%CI 1.373-3.530), underlying diseases > two kinds (OR=3.916,95%CI 1.736-8.832), CRP level >42.03 mg/L (OR=1.889,95%CI 1.027-3.475), hypoproteinemia (OR=2.326,95%CI 1.142-4.737), pneumonia severity index (PSI) grade 4-5 (OR=2.210,95%CI 1.279-3.818) and activities of daily living scale score at admission <90 points (OR=1.925,95%CI 1.196-3.100) were risk factors of QoL at discharge, and influenza and (or) pneumococcal vaccination (OR=0.259,95%CI 0.116-0.580) was a protective factor (P<0.05). The readmission rate and mortality due to CAP within one year of follow-up were obviously higher in the low-level group than the high-level group (P<0.05). Conclusion The QoL at discharge in elderly CAP survivors in emergency department is significantly lower than that of the norm. The status is affected by many factors, and it may also impact the prognosis. It is suggested that improving the QoL of the patients during hospitalization from various dimensions may have certain significance in improving the prognosis.

This work was supported by the National Natural Science Foundation of China ( 81770086) and the Natural Science Foundation forYoung Scholars of Jiangsu Province (BK20201078).