Diagnostic value of plasma heparin-binding protein and the heparin-binding protein-to-albumin ratio in patients with community-acquired Pneumonia: a retrospective study

Abstract Background Patients presenting to the emergency department with community-acquired pneumonia (CAP) are characterized by advanced age, comorbidities, critical illness and less-than-typical symptoms, posing a diagnostic challenge. Plasma heparin-binding protein (HBP) and the heparin-binding p...

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Main Authors: Xueqin Xiao, Yiyu Hong, Shuo Wang, Mingliu Ma, Zhaozhong Xu
Format: Article
Language:English
Published: BMC 2023-11-01
Series:BMC Infectious Diseases
Subjects:
Online Access:https://doi.org/10.1186/s12879-023-08762-3
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author Xueqin Xiao
Yiyu Hong
Shuo Wang
Mingliu Ma
Zhaozhong Xu
author_facet Xueqin Xiao
Yiyu Hong
Shuo Wang
Mingliu Ma
Zhaozhong Xu
author_sort Xueqin Xiao
collection DOAJ
description Abstract Background Patients presenting to the emergency department with community-acquired pneumonia (CAP) are characterized by advanced age, comorbidities, critical illness and less-than-typical symptoms, posing a diagnostic challenge. Plasma heparin-binding protein (HBP) and the heparin-binding protein-to-albumin ratio (HBP/Alb) have not been adequately studied in the early diagnosis of CAP. This study assessed the diagnostic value of plasma HBP, HBP/Alb, and conventional inflammatory markers in emergency department patients with CAP. Methods We enrolled 103 patients with CAP, retrospectively analyzed the patients’ clinical data, and divided the CAP patients into antibiotic (n = 79) and non-antibiotic (n = 24) groups based on whether antibiotics were administered prior to blood sampling and laboratory tests. The control group was comprised of 52 non-infected patients admitted during the same period. Within 24 h of admission, plasma HBP, serum procalcitonin (PCT), white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR) and HBP/Alb levels were collected separately and compared. The receiver operating characteristic (ROC) curve was plotted to assess the diagnostic value of each indicator for CAP patients. Utilizing the Kappa test, the consistency of each indicator used to evaluate CAP and clinical diagnosis was analyzed. Spearman correlation was used to analyze the correlation between plasma HBP and clinical indicators of CAP patients. Results Plasma HBP, serum PCT, WBC, NLR and HBP/Alb were all elevated in the CAP group in comparison to the control group (P < 0.001). Plasma HBP, serum PCT, WBC, NLR and HBP/Alb levels did not differ statistically between antibiotic and non-antibiotic groups (P > 0.05). Plasma HBP and HBP/Alb had the highest diagnostic accuracy for CAP, the area under the ROC curve (AUC) were 0.931 and 0.938 (P < 0.0001), and the best cut-off values were 35.40 ng/mL and 0.87, respectively. In evaluating the consistency between CAP and clinical diagnosis, the Kappa values for HBP, PCT, WBC, NLR and HBP/Alb were 0.749, 0.465, 0.439, 0.566 and 0.773, respectively. Spearman correlation analysis showed that plasma HBP was positively correlated with serum PCT, WBC, NLR and HBP/Alb in CAP patients (P < 0.001). Conclusions Plasma HBP and HBP/Alb have a high clinical diagnostic value for CAP and can be used as good and reliable novel inflammatory markers in the emergency department for the early diagnosis of CAP patients.
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spelling doaj.art-44cb1cec935c40618a98dae9247152332023-11-12T12:07:48ZengBMCBMC Infectious Diseases1471-23342023-11-012311810.1186/s12879-023-08762-3Diagnostic value of plasma heparin-binding protein and the heparin-binding protein-to-albumin ratio in patients with community-acquired Pneumonia: a retrospective studyXueqin Xiao0Yiyu Hong1Shuo Wang2Mingliu Ma3Zhaozhong Xu4Department of Emergency, Zhujiang Hospital, Southern Medical UniversityDepartment of Emergency, Zhujiang Hospital, Southern Medical UniversityDepartment of Emergency, Zhujiang Hospital, Southern Medical UniversityDepartment of Emergency, Zhujiang Hospital, Southern Medical UniversityDepartment of Emergency, Zhujiang Hospital, Southern Medical UniversityAbstract Background Patients presenting to the emergency department with community-acquired pneumonia (CAP) are characterized by advanced age, comorbidities, critical illness and less-than-typical symptoms, posing a diagnostic challenge. Plasma heparin-binding protein (HBP) and the heparin-binding protein-to-albumin ratio (HBP/Alb) have not been adequately studied in the early diagnosis of CAP. This study assessed the diagnostic value of plasma HBP, HBP/Alb, and conventional inflammatory markers in emergency department patients with CAP. Methods We enrolled 103 patients with CAP, retrospectively analyzed the patients’ clinical data, and divided the CAP patients into antibiotic (n = 79) and non-antibiotic (n = 24) groups based on whether antibiotics were administered prior to blood sampling and laboratory tests. The control group was comprised of 52 non-infected patients admitted during the same period. Within 24 h of admission, plasma HBP, serum procalcitonin (PCT), white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR) and HBP/Alb levels were collected separately and compared. The receiver operating characteristic (ROC) curve was plotted to assess the diagnostic value of each indicator for CAP patients. Utilizing the Kappa test, the consistency of each indicator used to evaluate CAP and clinical diagnosis was analyzed. Spearman correlation was used to analyze the correlation between plasma HBP and clinical indicators of CAP patients. Results Plasma HBP, serum PCT, WBC, NLR and HBP/Alb were all elevated in the CAP group in comparison to the control group (P < 0.001). Plasma HBP, serum PCT, WBC, NLR and HBP/Alb levels did not differ statistically between antibiotic and non-antibiotic groups (P > 0.05). Plasma HBP and HBP/Alb had the highest diagnostic accuracy for CAP, the area under the ROC curve (AUC) were 0.931 and 0.938 (P < 0.0001), and the best cut-off values were 35.40 ng/mL and 0.87, respectively. In evaluating the consistency between CAP and clinical diagnosis, the Kappa values for HBP, PCT, WBC, NLR and HBP/Alb were 0.749, 0.465, 0.439, 0.566 and 0.773, respectively. Spearman correlation analysis showed that plasma HBP was positively correlated with serum PCT, WBC, NLR and HBP/Alb in CAP patients (P < 0.001). Conclusions Plasma HBP and HBP/Alb have a high clinical diagnostic value for CAP and can be used as good and reliable novel inflammatory markers in the emergency department for the early diagnosis of CAP patients.https://doi.org/10.1186/s12879-023-08762-3Community acquired PneumoniaHeparin-binding protein
spellingShingle Xueqin Xiao
Yiyu Hong
Shuo Wang
Mingliu Ma
Zhaozhong Xu
Diagnostic value of plasma heparin-binding protein and the heparin-binding protein-to-albumin ratio in patients with community-acquired Pneumonia: a retrospective study
BMC Infectious Diseases
Community acquired Pneumonia
Heparin-binding protein
title Diagnostic value of plasma heparin-binding protein and the heparin-binding protein-to-albumin ratio in patients with community-acquired Pneumonia: a retrospective study
title_full Diagnostic value of plasma heparin-binding protein and the heparin-binding protein-to-albumin ratio in patients with community-acquired Pneumonia: a retrospective study
title_fullStr Diagnostic value of plasma heparin-binding protein and the heparin-binding protein-to-albumin ratio in patients with community-acquired Pneumonia: a retrospective study
title_full_unstemmed Diagnostic value of plasma heparin-binding protein and the heparin-binding protein-to-albumin ratio in patients with community-acquired Pneumonia: a retrospective study
title_short Diagnostic value of plasma heparin-binding protein and the heparin-binding protein-to-albumin ratio in patients with community-acquired Pneumonia: a retrospective study
title_sort diagnostic value of plasma heparin binding protein and the heparin binding protein to albumin ratio in patients with community acquired pneumonia a retrospective study
topic Community acquired Pneumonia
Heparin-binding protein
url https://doi.org/10.1186/s12879-023-08762-3
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