The Journal of Practical Medicine >
Effects of glucocorticoid on APACHE Ⅱ， SOFA scores and prognosis of elderly patients with severe pneumonia and respiratory failure
Received date: 2025-01-03
Online published: 2025-05-21
Objective To explore the application value of glucocorticoid in the treatment of elderly patients with severe pneumonia （SP） and respiratory failure （RF）. Methods A retrospective analysis was performed on the clinical data of 208 elderly patients with SP and RF in the hospital between January 2022 and December 2023. According to use of glucocorticoid or not， patients were divided into non-hormone group （n = 83） and hormone group （n = 125）. According to propensity score matching method， there were 71 patients in each group. The clinical indexes， disease improvement， blood gas indexes， laboratory biochemical indexes and prognosis were compared between the two groups. Results The ventilator use time and length of hospital stay in hormone group were shorter than those in non-hormone group （P < 0.05）. After 7 d of treatment， score of Glasgow coma scale （GCS）， oxygenation index （P/F）， blood oxygen saturation （SaO2） and lymphocyte count （TLC） in hormone group were higher than those in non-hormone group， while scores of acute physiological and chronic health evaluation Ⅱ （APACHE Ⅱ） and sequential organ failure assessment （SOFA）， partial pressure of carbon dioxide （PaCO2）， blood lactic acid （LAC） and procalcitonin （PCT） were lower than those in non-hormone group （P < 0.05）. The survival curves showed that 28 d survival rate in hormone group was higher than that in non-hormone group （P < 0.05）. Cox proportional hazard model showed that no use of glucocorticoids was an independent risk factor of 28d death in elderly patients with SP and RF （P < 0.05）. Conclusion Glucocorticoid can shorten ventilator use time and length of hospital stay， alleviate disease severity， promote the recovery of blood gas indexes， improve biochemical indexes and increase survival rate in elderly patients with SP and RF.
Key words： severe pneumonia; glucocorticoid; elderly; respiratory failure; prognosis
Kui YANG , Xuran PAN , Min. SHAO . Effects of glucocorticoid on APACHE Ⅱ， SOFA scores and prognosis of elderly patients with severe pneumonia and respiratory failure[J]. The Journal of Practical Medicine, 2025 , 41(10) : 1569 -1574 . DOI: 10.3969/j.issn.1006-5725.2025.10.020
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