实验室衰弱指数对老年CAP住院患者并发脓毒症及 脓毒性休克风险的预测价值.

Objective To investigate the value of laboratory frailty index (FI-LAB) in predicting the risk of sepsis and septic shock in elderly hospitalized patients with community-acquired pneumonia (CAP). Methods A total of 502 elderly CAP patients hospitalized in Chengdu Fifth People's Hospital were retrospectively included. Forty routine laboratory indexes and vital signs collected for the first time within 24 hours after admission were selected to construct FI-LAB. Patients with FI-LAB ≥ 0.35 were defined as the frail group, while patients with FI-LAB＜ 0.35 were defined as the non-frail group. The occurrence of sepsis and septic shock was observed. The predictive model was established by modified Poisson regression, and the predictive value was analyzed by the ROC curve of the subjects. Results Multivariate modified Poisson regression analysis showed that frailty was a risk factor for sepsis (P＜0.001) and septic shock (P=0.001) in elderly patients with CAP (P＜0.001). When FI-LAB was multiplied by 100 and included in the multivariate Poisson regression analysis, it was found that for every 0.01 increase in FI-LAB, the risk of sepsis and septic shock increased by 5.9% and 6.2% (both P＜0.001). The area under ROC curve of FI-LAB for predicting sepsis and septic shock was 0.865 and 0.850 (both P＜0.001), respectively, and the best cut-off values were 0.28 and 0.42, respectively. Conclusion Frailty increases the risk of CAP complications with sepsis and septic shock. FI-LAB can predict the risk of sepsis in CAP patients and detect high-risk groups early. [ABSTRACT FROM AUTHOR]