PORT评分对老年人社区获得性肺炎预后评估作用的研究

Effect of PORT score in the evaluation of prognosis of elderly patients with community acquired pneumonia

目的探讨PORT评分在老年人社区获得性肺炎(community acquired pneumonid,CAP)预后评估中的价值。方法收集某院呼吸内科收治的139例60岁以上CAP患者的临床资料,根据患者预后分为存活组和死亡组,并根据患者第1个24h内的临床资料进行PORT评分,绘制受试者工作曲线,对两组患者的一般情况和PORT评分分值进行分析,并比较不同PORT评分患者的预后。结果 139例患者中,存活91例,死亡48例,病死率为34.5%,存活组PORT评分为(96.85±22.94)分,低于死亡组(129.35±30.79)分(P<0.01)。PORT评分≤70分组、71～90分组、91～130分组以及>130分组的病死率分别为10.0%、13.9%、32.2%和67.6%,四组比较差异有统计学意义(P<0.01)。以PORT评分105作为判断患者最终死亡,灵敏度为79.2%,特异度为69.2%,ROC曲线下面积为0.803(95%CI:0.725～0.881,P=0.000)。结论 PORT评分评估老年人CAP病情及预后有一定的临床价值。

Objective To explore the value of PORT score in the evaluation of prognosis of elderly patients with community acquired pneumonia（ CAP） . Methods The clinical data of 139 elderly paitents with CAP was prospectively analyzed. According to the prognosis, the patients were divided into survivors and non-survivors groups, and the level of PORT score was calculated. Next, according to PORT score,patients were divided into ≤70 group, 71 - 90 group ,91 - 130 group and 〉 130 group, the mortality rate were observed. Results The level of PORT score was higher in non-survivors group than that in survivors group （ P 〈 0. 01 ）. Mortality rate in ~ 70 group, 71 - 90 group,91 - 130 group and 〉 130 group were 10. 0%, 13.9% ,32.2% ~ 67.6% （P 〈 0.01 ）. The sensitivity, speci- ficity and the diagnostic value of PORT score were 79. 2 %, 69.2% and 105, respectively, and the area under the ROC curve was known to be 0. 803 （95% （31：0. 725 -0. 881,P = 0. 000）. Conclusion PORT score is a good indicators for prognosis of elderly patients with CAP.