The Value Of Biomarkers And Their Changes In The Prognostic Assessment Of Severe Pneumonia

ObjectivesBy comparing the levels of common inflammatory markers and coagulation markers in the survival and death groups of severe pneumonia and the differences in their changes;their predictive value for the prognosis of severe pneumonia was investigated.MethodsA total of 1099 patients diagnosed with "severe pneumonia" in the Second Affiliated Hospital of Nanchang University from January 2019 to December 2021 were selected by retrospective analysis.70 cases were screened according to the inclusion and exclusion criteria of this study,and all the subjects’ names,gender,age,their combined related The results of PCT,coagulation tetralogy,DD,CRP,and routine blood tests at 1d,4d,and 7d after admission were collected and collated,and the levels of the test results in the survival and death groups were compared.SPSS 26.0 software was used to statistically analyze the collected data.Results(1)General information:the rate of concurrent infectious shock was lower in the survival group of severe pneumonia than in the death group,and the difference was statistically significant(P<0.05).There were no statistically significant differences between the two groups in terms of age,gender and their combined underlying diseas-es(P>0.05).(2)There was no significant difference in the proportion of abnormalities of PCT,WBC,NEU,and APTT between the survival group and the death group on the first day of admission(P>0.05).However,the proportion of abnormalities in the survival group decreased significantly on the seventh day,and the proportion of abnormalities in the death group increased significantly,with significant differences between the two groups(P<0.05).(3)Comparison of test result levels at each time point after admission between the survival group and the death group:PCT on day 7,WBC on days 5 to 7,NEU on days 4 to 7,NLR on days 5 to 7,INR,and APTT on days 4 and 7 were lower in the survival group than in the death group,and all differences were statistically significant(P<0.05).The differences in PCT,CRP,WBC on days 1 and 4,NEU on days 1 to 4,LY on days 1 to 3,NLR on days 1 to 4,DD,PT,APTT on day 1,Fib,and TT levels were not statistically significant(P>0.05)in the survival group compared with the death group.There were overall differences in the trends of WBC,NEU,NLR,PT,and APTT between the survival and death groups,and the differences were all statistically significant(P<0.05).(4)ROC was plotted according to PCT-7d,WBC-5d,WBC-6d,WBC-7d,NEU-4d,NEU-5d,NEU-6d,NEU-7d,NLR-5d,NLR-6d,NLR-7d,INR-1d,INR-4d,INR-7d,and APTT-7d levels,and each index was analyzed to predict severe pneumo-nia The AUCs for the ability of patients with 28-day survival outcome as death were 0.730,0.726,0.727,0.746,0.661,0.728,0.739,0.759,0.750,0.748,0.759,0.647,0.668,0.667,and 0.728,respectively(P<0.05).(5)Results of multifactorial logistic regression analysis of factors influencing prognosis in severe pneumonia:elevated PCT(OR=1.106;95%CI:1.021-1.198)on day 7 and elevated APTT(OR=1.191;95%CI:1.024-1.386)on day 7 were indepen-dent risk factors for poor prognosis in patients with severe pneumonia.Conclusions.(1)PCT,NLR,WBC,NEU,APTT,INR and the prognosis of severe pneumonia are related,and continuous monitoring and analysis of their changes are important tools to predict the prognosis of severe pneumonia.(2)Elevated PCT and APTT on day 7 are independent risk factors for poor prognosis in patients with severe pneumonia.