Valuation Of The Procalcitonin/Albumin Ratio On The Severity And Prognosis Of Community-Acquired Pneumonia

Objective:To explore the relevance between PAR and CAP in adults.Methods:A total of 309 inpatients with CAP were included in this retrospective study,including 164 patients in the common CAP group and 145 patients in the SCAP group.Patients with SCAP were further divided into survival group(116 cases)and death group(29 cases)on the basis of 28-day survival results.The baseline data of each group were collected,including age,gender,underlying disease,length of hospitalization,ICU admission,etc.The levels of PCT,CRP,ALB,NEU and LYM count within 24 hours after admission were collected,calculate the values of PAR,CAR,NLR.Univariate analysis and multivariate logistic analysis were performed to identify the independent risk factors for the severity and prognosis of CAP.A receiver operating characteristic(ROC)curve analysis was conducted to compare the predictive accuracy of the procalcitonin/albumin ratio.Results:(1)Patients in the SCAP group had higher age and hospital stay compared to those in the CAP group,and there were dramatic differences in sexual formation and diabetes between the two groups(P<0.001).The hospital stay in the death group was obviously shorter than that in the survival group(P<0.001).However,there was no significant difference between the two groups in terms of age,sex and complications(P>0.05).(2)PCT,CRP,NEU,NLR,CAR and PAR in SCAP group were significantly higher than those in CAP group,while LYM and ALB were the opposite(P<0.001).Compared with survivors,the levels of PCT,CRP,NLR,CAR and PAR in dead patients increased significantly,while the levels of ALB and LYM decreased significantly(P<0.01).(3)Based on multivariate logistic analysis,PAR(OR=1.193, 95%CI:1.117~1.275),CAR(OR=1.170,95%CI:1.001~1.367),NLR(OR=1.043,95%CI: 1.008~1.079)were independent risk factors for the exacerbation of CAP(P<0.05).There was no significant difference in age,sex and diabetes between the two groups.As for prognosis,the increase of PAR(OR=1.014,95% CI:1.009~1.020)was an independent risk factor for death in patients with SCAP(P<0.001),while there was no statistical significance between NLR and CAR(P>0.05).(4)In terms of predicting the severity of CAP,the area under the ROC curve of PAR is 0.980(AUC=0.980,P<0.001),which is the largest,and its sensitivity and specificity is 93.1% and 95.1% respectively.In the prediction of death for SCAP,PCT had the largest area under the curve(AUC=0.940,P < 0.001),followed by PAR(AUC=0.924,P < 0.001);However,compared with NLR and CAR,PAR showed greater predictive value in terms of severity and prognosis(P<0.001).Conclusion:(1)PAR,CAR and NLR were independent risk factors for the severity of CAP.(2)PAR is an independent risk factor for the prognosis of SCAP.(3)PAR has a higher predictive value for the severity of CAP and the prognosis of SCAP,and its value is higher than CAR and NLR.