Prediction value of neutrophil-to-lymphocyte ratio and soluble triggering receptor expressed on myeloid cell-1 for risk of aggravation of community-acquired pneumonia in elderly patients
10.3760/cma.j.cn311365-20241017-00293
- VernacularTitle:NLR、sTREM-1对老年社区获得性肺炎患者重症化风险的预测价值
- Author:
Chuanyu YIN
1
;
Xiaohua CHEN
;
Wenli ZHENG
;
Jianzhong DI
Author Information
1. 上海海洋大学水产与生命学院，上海 201306
- Publication Type:Journal Article
- Keywords:
Elderly community-acquired pneumonia;
Severe pneumonia;
Soluble triggering receptor expressed on myeloid cells-1;
Neutrophil-to-lymphocyte ratio
- From:
Chinese Journal of Infectious Diseases
2024;42(11):641-646
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the predictive value of the neutrophil-to-lymphocyte ratio (NLR) and soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) for the risk of severe community-acquired pneumonia (CAP) in elderly patients.Methods:A total of 109 elderly CAP patients admitted to Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from November 2023 to May 2024 were included. The patients were classified into severe group and non-severe group according to the severity of the disease. Inflammatory markers including NLR, sTREM-1, platelet-to-lymphocyte ratio (PLR), procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (IL-6) were compared between severe group and non-severe group. Levels of NLR, sTREM-1, and PLR on days one, four and seven after admission in 27 elderly patients with severe CAP were dynamically monitored. Statistical analyses were performed using two independent sample t-test and Mann-Whitney U test. The predictive factors for severe CAP in elderly patients were analyzed by multivariate logistic regression analysis, and receiver operating characteristic (ROC) curve was used to evaluate the efficacy of each indicator for predicting severe CAP in elderly patients. Results:There were 36 cases in severe group, and 73 cases in non-severe group. The levels of NLR, sTREM-1, PLR, PCT, CRP and IL-6 were significantly higher in the severe group than those in the non-severe group ( Z=-5.77, -3.48, -2.84, -3.94, -3.36 and -3.25, respectively; all P<0.01). Multivariate logistic regression analysis revealed that NLR and sTREM-1 were independent predictive factors for severe CAP in elderly patients (odds ratio ( OR) =1.112, 95% confidence interval ( CI) 1.000 to 1.235, P=0.049; OR=1.006, 95% CI 1.000 to 1.012, P=0.034). The ROC curve showed that the optimal cut-off value was 5.679 for NLR, and the area under the curve (AUC) was 0.841, with the sensitivity and specificity of 0.833 and 0.753, respectively. The optimal cut-off value of sTREM-1 was 151.275 ng/L (AUC was 0.731), with the sensitivity and specificity of 0.639 and 0.639, respectively. The AUC of the combined detection of NLR and sTREM-1 was 0.839, with the sensitivity and specificity of 0.944 and 0.630, respectively. The levels of sTREM-1 ((121.84±75.04) ng/L vs (179.06±85.44) ng/L), NLR (6.74±4.40 vs 11.87±7.78), and PLR (210.07±129.93 vs 294.91±187.61) on the 7th day of admission in 27 elderly patients with severe CAP were significantly lower than those on the 1st day ( t=-3.396, -3.492 and -3.396, respectively, P=0.005, 0.004 and 0.005, respectively). Conclusions:NLR and sTREM-1 have certain predictive value for the risk of severe CAP in elderly patients.
