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Serum suPAR associated with disease severity and mortality in elderly patients with community-acquired pneumonia.
Scandinavian Journal of Clinical and Laboratory Investigation ( IF 2.1 ) Pub Date : 2020-07-27 , DOI: 10.1080/00365513.2020.1795920
Shan Song 1 , Qinyao Jia 2 , Xiaoju Chen 1 , Zhen Lei 1 , Xinrong He 1 , Zhenwei Leng 1 , Shaoping Chen 1
Affiliation  

Abstract

Severe community-acquired pneumonia (SCAP) in elderly has more atypical clinical presentation compared to younger patients. Timely recognition could improve clinical care. This study investigated the value of soluble urokinase-type plasminogen activator receptor (suPAR) on severity assessment and outcome prediction in elderly patients with CAP. We conducted a prospective, observational study between January 2014 and December 2016. A total of 230 patients ≥65 were enrolled in this study, of which 151 were CAP and 79 were SCAP. Serum suPAR levels were determined by ELISA essays within 24 h after hospitalization. Thirty-day and 1-year mortalities were recorded as outcomes. Serum suPAR level was significantly increased in patients with SCAP. Positive correlation was found between suPAR levels with CURB-65 and PSI score (r = 0.423 and r = 0.489; p < .001 for both). The AUC for suPAR to discriminate SCAP patients from CAP was 0.783 at a cut-off value 4.27 ng/mL. AUCs of suPAR for predicting 30-day and 1-year mortalities were 0.815 (95% CI 0.746–0.866) and 0.820 (95% CI 0.770–0.870). Regression result shows suPAR (≥8.92 ng/mL) was independent factor for 30-day mortality (HR = 2.83, 95% CI 1.04–7.69) and suPAR with cut-off value 6.18 ng/mL could predict 1-year mortality (HR = 2.44, 95% CI 1.09–5.44). suPAR was strongly associated with CAP severity and could be a prognostic indicator for 1-year survival in elderly.



中文翻译:

血清 suPAR 与老年社区获得性肺炎患者的疾病严重程度和死亡率相关。

摘要

与年轻患者相比,老年人的严重社区获得性肺炎 (SCAP) 具有更多的非典型临床表现。及时识别可以改善临床护理。本研究调查了可溶性尿激酶型纤溶酶原激活剂受体 (suPAR) 在老年 CAP 患者的严重程度评估和结果预测中的价值。我们在 2014 年 1 月至 2016 年 12 月期间进行了一项前瞻性观察性研究。本研究共纳入 230 名≥65 名患者,其中 151 名为 CAP,79 名为 SCAP。在住院后 24 小时内通过 ELISA 论文测定血清 suPAR 水平。将 30 天和 1 年的死亡率记录为结果。SCAP患者血清suPAR水平显着升高。suPAR 水平与 CURB-65 和 PSI 评分呈正相关(r = 0.423 和r  = 0.489; 两者的p < .001)。suPAR 区分 SCAP 患者与 CAP 的 AUC 为 0.783,截断值为 4.27 ng/mL。suPAR 预测 30 天和 1 年死亡率的 AUC 为 0.815(95% CI 0.746–0.866)和 0.820(95% CI 0.770–0.870)。回归结果显示 suPAR(≥8.92 ng/mL)是 30 天死亡率(HR = 2.83,95% CI 1.04–7.69)的独立因素,截断值为 6.18 ng/mL 的 suPAR 可以预测 1 年死亡率(HR = 2.44, 95% CI 1.09–5.44)。suPAR 与 CAP 的严重程度密切相关,可能是老年人 1 年生存率的预后指标。

更新日期:2020-10-02
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