Title: Effect of sTREM-1 on prognosis of patients with ventilator-associated pneumonia
Abstract: Objective
To explore the prognostic value of soluble triggering receptor expressed on myeloid cells-1(sTREM-1) in patients with ventilator-associated pneumonia (VAP).
Methods
A total of 103 VAP patients were enrolled from June 2013 to May 2015 in the ICU of Wuxi People’s Hospital Affiliated to Nanjing Medical University. The demographics and clinical data were collected, while serum sTREM-1, procalcitonin (PCT), C-reactive protein(CRP), clinical pulmonary infection score(CPIS) and acute physiology and chronic health evaluationⅡ(APACHE Ⅱ) were measured. Patients were divided into the death group and the survival group according to 28 d survival. The differences in demographics and clinical data were compared between groups.The values of sTREM-1, PCT, CPIS and APACHEⅡ for predicting 28 d death were evaluated by receiver operating curves(ROC). The surviving curve was drawn by Kaplan-Meier method. The possible prognostic factors were analyzed by univariate and logistic multivariate analysis.
Results
There were 76 patients in the survival group and 27 patients in the death group, and there was no difference in demographics between two groups(P>0.05). The serum sTREM-1, PCT, CPIS and APACHEⅡ were higher in the death group[(89.50±18.45) pg/mL, (823.86±182.74) pg/mL, (7.20±1.74) and (19.58±3.43)] than those in the survival group[(54.09±12.71) pg/mL, (579.81±193.45) pg/mL, (4.79±1.93) and (17.23±3.12), all P<0.05]. The areas under the ROC of sTREM-1, PCT, CPIS and APACHEⅡ for predicting 28 d death were 0.84±0.04(95%CI:0.75-0.92, P<0.01), 0.65±0.05(95%CI:0.55-0.74, P=0.49), 0.67±0.06(95%CI:0.55-0.79, P<0.01), 0.79±0.04(95%CI:0.70-0.87, P=0.03), respectively. Patients were assigned into two groups by the best cutoff point of sTREM-1=75.00 pg/mL, and Kaplan-Meier survival analysis showed that 28 d survival rate in the low sTREM-1 group was significantly higher than that in the high sTREM-1 group (82.5% vs. 63.4%, χ2=3.96, P<0.05). Multivariate logistic regression analysis showed that both sTREM-1 (OR=1.08,95%CI:1.04-1.13,P<0.01) and APACHEⅡ (OR=1.39,95%CI:1.15-1.67,P<0.01) were risk factors associated with 28 d death.
Conclusions
Early serum sTREM-1 can be used as a reliable predictor for the outcome of patients with VAP.
Key words:
Ventilator-associated pneumonia; Soluble triggering receptor expressed on myeloid cells-1; Acute physiology and chronic health evaluation; Prognosis
Publication Year: 2018
Publication Date: 2018-01-10
Language: en
Type: article
Access and Citation
AI Researcher Chatbot
Get quick answers to your questions about the article from our AI researcher chatbot