Quick Pitt bacteremia score combined with lactate predicts the mortality risk in the patients with acute lower respiratory tract infection

Liu Wenxin; Zhang Ye; Liang Menglin; Teng Fei; Mei Xue

doi:10.3969/j.issn.1002-1949.2024.06.012

Abstract：Objective To investigate whether Pitt quick bacteremia(qPitt)score combined with common laboratory indicators in emergency department could be used as the predictors of 28-day mortality risk in acute lower respiratory tract infection patients.Methods A retrospective study was conducted on the patients with acute lower respiratory tract infection who were admitted to the Emergency Department of Beijing Chaoyang Hospital,Capital Medical University from July 1,2018 to December 31,2023.The patients were divided into survival group and death group according to the 28-day prognosis after admission.The differences of clinical indicators and qPitt score between the two groups were analyzed through univariate analysis.Logistic regression was used to screen the independent factors associated with 28-day mortality in acute lower respiratory tract infection patients,and a combined prediction model was established.The predictive value of independent correlation factors and combined variable model for 28-day mortality in acute lower respiratory tract infection patients was evaluated by using receiver operating characteristic(ROC)curves.Results A total of 696 patients were enrolled in this study,including 445 cases(63.9％)in the survival group and 251 cases(36.1％)in the death group.The age,procalcitonin,D-dimer,blood lactate(LAC),serum creatinine(SCr)and qPitt score in the death group were higher than those in the survival group(P＜0.05),while the numbers of lymphocyte and platelet in the death group were lower than those in the survival group(P＜0.05).Logistic regression analysis showed that LAC(OR=1.258,95％CI 1.143-1.384,P＜0.001),age(OR=1.021,95％CI 1.008-1.034,P=0.001)and qPitt score(OR=1.923,95％CI 1.597-2.317,P＜0.001)were independent factors of 28-day mortality risk in acute lower respiratory tract infection patients.The area under ROC curve(AUC)of the combined variable model of age,LAC and qPitt score was 0.746(95％CI 0.708-0.784),which was higher than that of LAC(AUC=0.692,95％CI 0.650-0.733)and qPitt score(AUC=0.702,95％CI 0.660-0.743),and the prediction efficacy of combined variable model was superior to that of LAC(Z=2.888,P=0.004)and qPitt score(Z=3.850,P＜0.001)alone.Conclusions qPitt score and LAC are independent risk factors for 28-day mortality in acute lower respiratory tract infection patients,and the combined variable model established by qPitt score,LAC and age could effectively predict the 28-day mortality risk.