title: Prognostic factors for community-acquired pneumonia in middle-aged and elderly patients treated with integrated medicine.
abstract: OBJECTIVE
  To identify prognostic factors in middle-aged and elderly patients with community-acquired pneumonia (CAP) who underwent integrated interventions involving traditional Chinese medicine (TCM) and modern medicine.
  
  
  METHODS
  Patients aged > or =45 years and diagnosed with CAP were divided into a middle-aged cohort (45-59 years) and an elderly cohort (> or =60 years), and clinical data comprising 75 predictor variables in seven classes were collected. After replacing missing data, calibrating multicenter differences and classifYing quantitative data, univariate and multivariate analysis were performed.
  
  
  RESULTS
  On multivariate analysis, eight independent risk factors--respiration rate, C reactive protein (CRP), cost of hospitalization, anemia, gasping, confusion, moist rales and pneumonia severity index (PSI)--were correlated with the outcome "not cured" in the elderly cohort. Nine factors--neutrophil percentage (Neu%), blood urea nitrogen (BUN), time to clinical stability, appetite, anemia, confusion, being retired or unemployed, Gram-negative bacterial infection and educational level were correlated with not cured in the middle-aged cohort.
  
  
  CONCLUSIONS
  Independent predictive risk factors correlated with adverse outcomes in elderly patients were higher respiration rate, CRP > or = four times the mean or median for the patient's center, cost of hospitalization >11,323 RMB and PSI >11, plus anemia, gasping, confusion and moist rales; those in middle-aged patients were higher Neu%, BUN > or = mean or median, loss of appetite, anemia, confusion, being retired or unemployed and lower educational level. Gram-negative bacterial infection and time to clinical stability >9 days were protective factors.
authors.affiliation: Geriatric Department, Henan College of Traditional Chinese Medicine, Zhengzhou, Henan 450008, China. li_js8@163.com
authors.forename: Jian-sheng
authors.initials: JS
authors.lastname: Li
authors.forename: Zheng-kun
authors.initials: ZK
authors.lastname: Hou
authors.forename: Xue-qing
authors.initials: XQ
authors.lastname: Yu
authors.forename: Su-Yun
authors.initials: SY
authors.lastname: Li
authors.forename: Zi-kai
authors.initials: ZK
authors.lastname: Sun
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Xin-hua
authors.initials: XH
authors.lastname: Jia
authors.forename: Si-ping
authors.initials: SP
authors.lastname: Zheng
authors.forename: Ming-hang
authors.initials: MH
authors.lastname: Wang
authors.forename: Hai-feng
authors.initials: HF
authors.lastname: Wang
mesh_terms: D000367:Age Factors; D000368:Aged; D001806:Blood Urea Nitrogen; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D015999:Multivariate Analysis; D011014:Pneumonia / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D012307:Risk Factors