Evaluation of early blood inflammation indicators on the prognosis of patients with severe community-acquired pneumonia
Objective To evaluate the prognostic value of early blood inflammatory indicators in patients with respiratory failure caused by severe community-acquired pneumonia. Methods A total of 186 patients diagnosed with respiratory failure due to severe pneumonia on admission were recruited in this study....
| Main Author: | |
|---|---|
| Format: | Article |
| Language: | zho |
| Published: |
Editorial Office of Journal of New Medicine
2024-03-01
|
| Series: | Xin yixue |
| Subjects: | |
| Online Access: | https://www.xinyixue.cn/fileup/0253-9802/PDF/1712537301956-57838758.pdf |
| Summary: | Objective To evaluate the prognostic value of early blood inflammatory indicators in patients with respiratory failure caused by severe community-acquired pneumonia. Methods A total of 186 patients diagnosed with respiratory failure due to severe pneumonia on admission were recruited in this study. According to clinical prognosis， they were divided into the death group （<i>n = </i>42） and improvement group （<i>n = </i>144）. Twelve cytokines， ferritin， C-reactive protein， procalcitonin， blood routine examination and blood gas analysis results of the patients within two days after admission were analyzed. Pneumonia severity index （PSI） and APACHE Ⅱ scores of the patients were collected. The correlation between the above indicators and prognosis was explored. Results Compared with the improvement group， the levels of IFN-γ， IL-10， IL-6， IL-8， C-reactive protein （CRP）， procalcitonin and ferritin were significantly higher in the death group （all <i>P < </i>0.05）. Upon admission， the hemoglobin level and platelet count in the death group were significantly lower than those in the improvement group （both <i>P < </i>0.05）. The PSI and APACHE Ⅱ scores on admission in the death group were significantly higher compared with those in the improvement group （both <i>P < </i>0.05）. Patients in the death group had higher lactic acid level and lower oxygenation index （OI） compared with their counterparts in the improvement group （both <i>P < </i>0.05）. Multivariate Logistic regression analysis revealed that IL-6， ferritin， PSI and APACHE Ⅱ scores and lactic acid level were the risk factors for poor prognosis， whereas platelet count was the protective factor for poor prognosis （all <i>P < </i>0.05）. The receiver operating characteristic （ROC） curve indicated that IL-6，procalcitonin and ferritin were favorable predictors for clinical prognosis of patients. When IL-6 and ferritin levels exceed 11.41 ng/L and 659 μg/L， and platelet count was less than 148.5×10<sup>9</sup>/L， patients were at risk of death. Conclusions In patients with respiratory failure caused by severe community-acquired pneumonia， the increase of blood inflammatory indicators， such as IL-6， ferritin and procalcitonin， suggests high risk death in patients， especially for patients with IL-6 >11.41 ng/L， ferritin>659 μg/L， and platelet count<148.5×10<sup>9</sup>/L. Extensive attention should be paid to lowering the risk of death in these patients. |
|---|---|
| ISSN: | 0253-9802 |