Analysis of clinical characteristics and risk factors of community-acquired pneumonia complicated by parapneumonic pleural effusion in elderly patients

Abstract

Abstract Bcckground: Community acquired pneumonia (CAP) patients usually combine with parapneumonic pleural effusion (PPE), and complicates the treatment of pneumonia. This study aimed to investigate the clinical characteristics and risk factors of community acquired pneumonia (CAP) patients hospitalized with parapneumonic pleural effusion (PPE) in elderly. Methods The clinical data of 132 elderly patients with CAP were retrospectively analyzed. 54 patients with PPE (PPE group) and 78 patients without PPE [NPPE (non parapneumonic pleural effusion) group] were included in this study. Clinical data, laboratory examination, treatment and other related indicators were collected. Univariate analysis and multivariate Logistic regression analysis will be used to explore the possible risk factors for PPE. Results PPE patients were significantly more likely to be older, comorbid with neurological diseases, occur chest tightness and lasting fever (t = − 2.351, χ༒ = 4.175, χ༒ = 14.103, t = − 2.242, P < 0.05). In contrast to NEEP patients, the total number of lymphocytes, serum albumin and blood sodium levels in PPE group were significantly lower (Z = − 2.634, t = 3.597, t = 2.153, all P < 0.05), blood D-dimer and C-reactive protein (CRP) were significantly higher (Z = − 2.254, t = − 2.380, all P < 0.05), the CURB-65 score was significantly higher (t = -3.543, P = 0.001), the use rate of carbapenems or glycopeptides antibiotics was higher (χ༒ = 5.641, P = 0.018), the length of hospital stay was longer (t=-2.073, P = 0.04), and the in-hospital mortality of PPE patients was significantly higher (χ༒ = 12.551, P < 0.001). Multivariate Logistic regression analysis showed that chest tightness (OR = 3.964, 95%CI: 1.254 ~ 12.537, P = 0.019), long duration of fever (OR = 1.108, 95%CI: 1.009 ~ 1.217, P = 0.032), low serum albumin (OR = 0.876, 95%CI: 0.790 ~ 0.971, P = 0.012) and low blood sodium (OR = 0.896, 95%CI: 0.828 ~ 0.969, P = 0.006) were significant risk factors for elderly CAP patients combine with PPE. Conclusion A risk factor analysis was performed, elderly patients with CAP have a higher incidence of PPE, higher mortality and longer hospital stay. Chest tightness, long duration of fever, low serum albumin and low blood sodium are risk factors for PPE.