1. The effect of immunosuppression on outcomes in elderly patients with community-acquired pneumonia
- Author
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Lixue Huang, Bingxuan Weng, Yuanqi Wang, Mengyuan Wang, Yin Mei, Wei Chen, Meng Ma, Jingnan Li, Jianzhen Weng, Yang Ju, Xuefeng Zhong, Xunliang Tong, and Yanming Li
- Subjects
Community-acquired pneumonia ,Immunocompromised ,Elderly ,Outcomes ,Diseases of the respiratory system ,RC705-779 - Abstract
Abstract Background The effect of immunosuppression on clinical manifestations and outcomes was unclear in elderly patients with CAP. Methods Elderly hospitalised patients with CAP were consecutively enrolled and were divided into immunocompromised hosts (ICHs) or non-ICHs groups. Clinical manifestations, severity, and outcomes were compared. The logistic regression model was used to determine the association between immunosuppression and outcomes. The primary outcome was 30-day mortality. Results A total of 822 patients were enrolled, of whom 133 (16.2%) were immunocompromised. There were no differences between the two groups in vital signs, oxygenation, admission laboratory tests, need for mechanical ventilation and intensive care unit admission, except for a lower lymphocyte count in the ICH group (0.9*10^9/L, IQR 0.6–1.3*10^9/L [ICH group] vs. 1.2*10^9/L, IQR 0.8–1.7*10^9/L [non-ICH group]; p 0.05). After adjusting for age, sex, and comorbidities, immunosuppression was significantly associated with a higher risk of 30-day mortality (odds ratio 5.004, 95% CI [2.618–9.530]). Conclusions Immunosuppression was independently associated with an increased risk of 30-day mortality. CURB-65 may underestimate the mortality risk of ICHs.
- Published
- 2025
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