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Clinical characteristics and prognosis of community-acquired pneumonia in autoimmune disease- induced immunocompromised host: A retrospective observational study

摘要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 neutrophil-to-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.

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作者单位 Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China [1] Department of Pharmacology, University of Virginia School of Medicine Charlottesville, Virginia, USA [2]
栏目名称 Original Articles
DOI 10.5847/wjem.j.1920-8642.2020.03.003
发布时间 2020-05-21
基金项目
the Shanghai Traditional Medicine Development Project the National Natural Science Foundation of China the Zhongshan Hospital Distinguished Young Scholars and the Shanghai Municipal Planning Commission of science and Research Fund Key Project of Shanghai Municipal Health Bureau
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