Background: Severe community-acquired pneumonia (SCAP) is a serious health threat in elderly individuals, and a prospective, observational study was conducted to explore the prognostic factors.Methods: Patients (≥65 years old) with SCAP that had an intensive care unit (ICU) stay >24 h were recruited at our center. Clinical and laboratory data were collected and various assessment scores were calculated. The follow-up period was censored at the date of death or at hospital discharge, whichever came first.Results: A total of 120 elderly patients with SCAP were included. Among them, 61 were cured (survival group) and 59 died due to SCAP (mortality group). Multivariate logistic regression analysis showed that chronic obstructive pulmonary disorder (COPD, β=2.061, P=0.008) and CD3+CD4+ T cell count (β=−0.019, P=0.017) were independent prognostic factors for death in elderly patients with SCAP. The area under the receiver operating characteristic (ROC) curve (AUROC) for the age-and gender-adjusted model was estimated to be 0.915 [95% confidence interval (CI): 0.858-0.972] for mortality, and the sensitivity and specificity of the model were 91.53% and 86.89%, respectively.Conclusions: Our findings suggest that COPD and the CD3+CD4+ T cell count are independent prognostic factors for mortality, and the constructed model was moderately accurate in the prediction of mortality for elderly patients with SCAP.

Study Objectives: Left ventricular hypertrophy (LVH) is associated with augmented risk for mortality in patients with coronary artery disease (CAD). These patients often have obstructive sleep apnea (OSA). We aimed to evaluate the relationship between OSA and the left ventricular mass index (LVMI) in men with CAD. Methods: Consecutive patients with CAD were recruited and underwent overnight portable monitoring for the assessment of OSA. LVMI was ascertained using highresolution echocardiography. Univariate and multivariate regression analyses were conducted to explore the associations between the OSA parameters and the LVMI levels. Results: Of the 1,053 examined male patients with CAD, 425 (40.4%) had moderate-to-severe OSA (respiratory event index ≥ 15 events/h). The prevalence of LVH (LVMI > 125 g/m 2 ) was 36.0% (n = 379). The mean LVMI values increased with increasing OSA severity (P <.001). Patients with respiratory event index ≥ 30 events/h had 2.30 (95% confidence interval 1.50-3.54, P < .001) times increased risk of LVH than those without OSA (respiratory event index < 5 events/h) independent of confounders. The minimum oxygen saturation levels were the strongest factor correlated with LVMI (β = −0.299, P =.004) of several OSA indices. Patients with minimum oxygen saturation < 70% had an adjusted odds ratio of 3.62 (95% confidence interval 1.81-7.25, P <.001) for LVH development compared with those with minimum oxygen saturation ≥ 90%. Conclusions: OSA severity was associated with a higher likelihood of LVH in men with CAD, which is partially related to severe nocturnal intermittent hypoxemia. Aggressive effort at managing OSA among patients with CAD may further reduce the cardiovascular risk.

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