Value of prognostic assessment of soluble triggering receptor expressed on myeloid cell-1, high-sensitivity C-reactive protein combined with the Acute Physiology and Chronic Health Evaluation Ⅱ score in patients with pneumonia complicated with respiratory failure

  Objective  To study the value of prognostic assessment of soluble triggering receptor expressed on myeloid cell-1 (sTREM-1), high-sensitivity C-reactive protein(hs-CRP)combined with the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score in patients with severe pneumonia complicated with respiratory failure.

  Methods  A total of 106 patients with severe pneumonia complicated with respiratory failure were selected as observation group, and 108 patients with mild pneumonia were randomly selected as control group; A total of 106 patients with pneumonia complicated with respiratory failure were divided into survival group (n=82) and death group (n=24) according to the 30 d prognosis. The levels of sTREM-1, hs-CRP and APACHE Ⅱ score of all the patients were detected; the diagnostic efficacy of serum sTREM-1, hs-CRP combined with APACHE Ⅱ score for the poor prognosis of patients with pneumonia complicated with respiratory failure was analyzed; the risk factors influencing the poor prognosis of patients with pneumonia complicated with respiratory failure were analyzed.

  Results  The serum levels of sTREM-1, hs-CRP and APACHE Ⅱ score in the observation group were significantly higher than those in the control group (P < 0.05). The serum levels of sTREM-1, hs-CRP and APACHE Ⅱ score in the death group were significantly higher than those in the survival group (P < 0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of sTREM-1, hs-CRP and APACHEⅡscore were 0.835, 0.796 and 0.866, respectively, the sensitivities were 82.80%, 93.10% and 75.90%, respectively, and the specificity was 80.50%, 58.40% and 89.60%, respectively. The AUC of combined detection was 0.938, the sensitivity was 79.20%, and the specificity was 93.10%. The sTREM-1, hs-CRP and APACHE Ⅱscore were independent risk factors for poor prognosis of patients with pneumonia complicated with respiratory failure (P < 0.05).

  Conclusion  The sTREM-1, hs-CRP and APACHE Ⅱ score have good diagnostic value for the prognosis of patients with pneumonia complicated with respiratory failure, and can provide theoretical basis for clinical timely adjustment of treatment plan.