Predictive Value Of Platelet/Lymphocyte Ratio And Serum Amyloid A On Severity Of Community-Acquired Pneumonia

Objectives The purpose is to study and predict the severity of platelet to lymphocyte ratio(PLR)and serum amyloid A(SAA)on community-acquired pneumonia(CAP),It is helpful for clinicians to assess the severity of patients,screen high-risk patients early and timely take appropriate treatment measures to alleviate the patient’s condition and prevent further aggravation.Methods Based on the inclusion and exclusion criteria,277 adult patients with community-acquired pneumonia were hospitalized in the first ward of the Department of respiratory and critical medicine of the Affiliated Hospital of North China University of Science and Technology from October 2019 to October 2021 were selected as the research object.and were grouped according to the severity of pneumonia.(CURB-65 score)is divided into indicators,the enrolled patients were divided into a total of 211 patients in the mild-moderate group and 66 patients in the severe group.Single-factor analysis and multiple logistic regression analysis were used to screen out independent risk factors and predict the predictive relationship between PLR,SAA,and CAP severity.Through the screened independent risk factors PLR and SAA,the forest map in Graph Pad software is displayed.Then,the Nomogram prediction model is carried out in the R software,and the correction curve is constructed to evaluate the authenticity and accuracy of the prediction model.Finally,the critical values of PLR and SAA are selected through the receiver operating characteristic(ROC)curve,and the sensitivity,specificity,and kappa values are calculated to evaluate the accuracy of the prediction model,Thus,the clinical application value of nomogram prediction model is selected.Results 1 Univariate analysis(chi-square,t-test,or rank-sum test)between mild-moderate,and severe CAP groups adjusted for age,serum prealbumin(PA),gender,smoking history,underlying disease,hemoglobin(HB),pulmonary infiltrate status,respiratory rate≥30breaths/min Neutrophil to lymphocyte ratio(NLR),blood urea nitrogen(BUN),D-dimer,hypersensitive C-reactive protein(hs-CRP),albumin(ALB),procalcitonin(PCT),PLR,serum creatinine(Scr),Erythrocyte sedimentation rate(ESR)and SAA were compared and the differences were statistically significant(P>0.05),indicating that the above factors may increase the risk of severity in CAP patients.However,alcohol consumption history,pulmonary nodules,temperature,pulse,hypotension,red cell distribution width(RDW),packed cell volume(PCV),serum sodium,aspartate aminotransferase(AST),alanine aminotransferase(ALT)were compared between the two groups,it is the difference was not statistically significant(P>0.05).2 Multivariate analysis: PLR,SAA,and BUN were independent risk factors for the severity of CAP in the mild-moderate group and severe group(P<0.05),while gender,underlying disease,lung infiltration status,age,and respiratory rate ≥ 30 times/min,smoking history,Hb,NLR,Alb,PA,Scr,D-dimer,ESR,hs-CRP,and PCT were not independent risk factors for the severity of CAP in patients(P>0.05).3 The line forest plots of PLR and SAA in Graph Pad software showed that the magnitudes of the index values were all positively associated with the severity of CAP(OR>6).4 Using R software to maximize the integration of PLR and SAA,the nomogram model for predicting the severity analysis of CAP patients was drawn,and the calibration curve was drawn to maximize the trueness and accuracy of the prediction model.5Evaluation of the nomogram prediction model: the ROC curve analysis affecting the severity of CAP patients was performed by calculating the nomogram PLR and the sum of SAA scores,and the predictive cut-off value was found by calculating the Youden index,calculating the kappa value,and the model had an area under the curve(AUC)of 0.889,a sensitivity of 77.3%,a specificity of 85.3%,and a kappa value of 0.578,With better predictive values and computational results.Conclusions 1 PLR and SAA are independent risk factors for CAP,which are related to predicting the severity of CAP patients.PLR,SAA levels increased,the more severe the CAP patients.2 The established nomogram model for predicting the severity of CAP patients has certain accuracy,and early identification and intervention of critically ill patients have certain guidance and application value for clinicians.Figure 7;Table 13;Reference 195...