基于老年衰弱量表的社区获得性肺炎患者早期胸部螺旋CT扫描获益与风险评估OA

Objective:To explore the influences of differently clinical frailty status on baseline characteristics,laboratory biomarkers,imaging findings,clinical endpoints,and financial burden of medicine of patients with community acquired pneumonia(CAP).Methods:A total of 80 CAP patients admitted to The People's Hospital of Bozhou between February and December 2025 were enrolled.Based on the scores of fatigue,resistance ambulation illnesses loss of weight(FRAIL)scale,they were divided into three groups:non-frailty group(n=32,FRAIL score was 0),pre-frailty group(n=32,FRAIL scores were from 1 to 2),and obvious frailty group(n=16,FRAIL scores were from 3 to 5).The baseline data,inflammatory markers,CT imaging characteristics,transfer rates of intensive care unit(ICU),medical expenditure and net benefit index,as well as CURB-65 scores(including blurred consciousness,urea nitrogen of blood,respiratory rate,blood pressure,and age≥65 years old),were compared among three groups.Results:CT scan demonstrated that the scores of cumulative pneumonia involvement of non-frailty group,pre-frailty group and obvious frailty group were respectively 2.45±0.87,3.12±1.05,3.87±1.24,and cumulative pneumonia involvement of obvious frailty group was respectively larger than that of non-frailty group and pre-frailty group,and the differences were significant(F=12.453,P<0.05).Thoracic effusion and modification rate of treatment of obvious frailty group was higher,and the differences of them were significant among three groups(x2=5.351,9.327,P<0.05).The ages and CURB-65 scores of patients of obvious frailty group were significantly higher than those of other two groups,and the differences were significant(F=12.126,15.437,P<0.05),while blood oxygen saturation of obvious frailty group was significantly lower than that of other two groups(F=11.876,P<0.05).The C-reactive protein and procalcitonin levels of obvious frailty group were higher than those of other two groups,and the differences were significant(H=22.145,28.763,P<0.05).The serum albumin of obvious frailty group was lower than that of other two groups,and the differences were significant(F=12.874,15.327,P<0.05).In addition,the hospitalization time and medical expenditure of obvious frailty group were higher than those of other two groups(H=9.357,10.028,P<0.05),while the incidence of composite adverse outcomes was higher than that of other two groups,and the difference was significant(x2=8.289,P<0.05).Of note,the net benefit index gradually decreased with the increasing of frailty degree.Conclusion:The degree of clinical frailty is significantly correlated with severity of inflammatory response,lesion extent of imaging,consumption of medical resource,and risk of adverse outcomes.The combined assessment can provide basis for individualized treatment.