Correlation Between Glycosylated Serum Protein And Short-term Prognosis Of Severe Pneumonia

Objective:A retrospective study of patients with severe pneumonia was conducted to explore the correlation between abnormal glycosylated serum protein and 90-day mortality in patients with severe pneumonia.Methods:172 patients admitted to ICU due to severe pneumonia in the First Affiliated Hospital of Nanchang University from January 2019 to September 2021 were collected retrospectively.According to the glycosylated serum protein(GSP)value detected at admission,they were divided into Q1-GSP normal group(1.7-2.5mmol/L),Q2-low GSP group(< 1.7mmol/L)and Q3-high GSP group(>2.5mmol/L),with 99,39 and 34 patients respectively.The basic information,laboratory examination results,advanced life support after admission and cardiovascular events during hospitalization were compared among the three groups.The correlation between the above indexes and the 90-day mortality of severe pneumonia was analyzed by univariate and multivariate Cox regression.Results:The death toll of all patients in 90 days was 78(45.3%),of which 30(30.3%)died in normal GSP group,25(64.1%)in low GSP group and 23(67.6%)in high GSP group.The mortality of high GSP group and low GSP group was higher than that of normal GSP group(P<0.001).The rates of CRRT treatment(35.29% vs.14.14%,P=0.027)and cardiovascular events(35.29% vs.11.11%,P=0.004)in group Q3 were higher than those in group Q1.The proportion of pre-existing diabetic patients(70.59% vs.34.34%,17.59%,P<0.001),creatinine(195.75 umol/L vs.77.80 umol/L,65.30 umol/L,P<0.001),C-reactive protein(225.62 mg/L vs.107.00mg/L,78.90 mg/L,P<0.001),Procalcitonin(4.47 ng/m L vs.1.72 ng/m L,1.09 ng/m L,P=0.002)in group Q3 were higher than those in group Q1 and group Q2.Multiple factors regression analysis showed that GSP<1.7 mmol/L(HR 1.81,95 CI 1.02-3.21,P=0.044),GSP>2.5 mmol/L(HR 2.38,95 CI 1.36-4.18,P=0.002),age> 65 yeas old(HR 2.27,95 CI 1.39-3.71,P=0.001),Occurrence of cardiovascular events(HR2.47,95 CI 1.51-4.04,P<0.001),required vasoactive drugs(HR 4.39,95 CI 2.08-9.28,P<0.001),C-reactive protein>100mg/L(HR 1.95,95 CI 1.19-3.20,P=0.008)were associated with 90-day mortality in patients with severe pneumonia.Conclusions:1.High(> 2.5 mmol/L)or low(< 1.7 mmol/L)GSP levels were associated with90 day mortality in patients with severe pneumonia.2.Patients with elevated GSP had higher levels of creatinine,CRP and PCT at admission.3.Age > 65 years old,CRP > 100mg/L,cardiovascular events and the need for vasoactive drugs may be independent risk factors for death in patients with severe pneumonia.