Predictive value of protein C for long-term mortality of patients with community-acquired pneumonia / 中国基层医药

ABSTRACT

Objective To investigate the predictive value of protein C( PC) for long -term mortality of patients with community-acquired pneumonia(CAP).Methods A total of 657 patients with CAP were enrolled in Taian Central Hospital from January 2011 to December 2011.The patients were divided into short-term group(≤30 days),medium-term group(>30~90 days) and long-term group(>90 days).PC,high sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT),pneumonia severity index(PSI) score and CURB-65 score were measured at the time of admission.The ROC curve was used to evaluate the independent risk factors.The Kaplan-Meier surviv-al function curve was used to analyze the difference of mortality between the short-term group and long-term group. Independent risk factors for CAP risk were analyzed by COX regression.Results A total of 597 cases were followed up,there were 49 cases(8.09% ) in the short-term group,11 cases(1.84% ) in the medium -term group,and 537 cases(89.93% ) in the long-term group.The PC levels in the short-term group,medium-term group and long-term group were (32.2 ± 10.6)% ,(43.1 ± 9.9)% ,(69.6 ± 23.0)% ,respectively.The level of PC was signifi-cantly increased in the short-term group compared with the medium-term group and long-term group ( short-term group vs.medium-term group,q =6.18,P <0.05,short -term group vs.long -term group,q=9.87,P <0.05).The hs-CRP levels in the short-term group,medium-term group and long-term group were (108.1 ± 22.4)mg/L,(68.2 ± 12.9 ) mg/L, ( 25.1 ± 17.1 ) mg/L, respectively. The level of hs - CRP was significantly increased in the short-term group compared with the medium-term group and long-term group (short-term group vs.medium-term group, q =5.23, P <0.05, short -term group vs. long -term group, q =12.95, P<0.05 ). Meanwhile,PC showed higher accuracy(AUC,0.889) than CURB-65( AUC,0.828) and hs-CRP( AUC,0.711) in the long-term group.The Kaplan-Meier survival function curve showed that the mortality rate was significantly higher in the high-value group compared with the low-value group(F=17.10,P<0.01).PC was an independent factor for long - term mortality and was associated with poorer survival by the COX regression analysis. Conclusion PC has a high predictive value for long-term mortality in CAP patients.