Longitudinal Associations Of Serum Survivin With The Severity And Prognosis Of Community-acquired Pneumonia Patients

Background: Community-acquired pneumonia(CAP)is one of the most common infections in emergency department patients.It usually presents as a relatively mild illness;however,remains an important cause of morbidity and mortality.Under such circumstances,the immediate initiation of a rational diagnosis and treatment is needed to reduce mortality for better therapeutic effect.Survivin is a member of apoptosis inhibitor proteins that evokes cellular proliferation and inhibits apoptosis.However,the role of survivin in community-acquired pneumonia(CAP)patients remains to be firmly established.Objective: The aim of this cohort study was to evaluate the correlations of serum survivin with the severity and prognosis of CAP patients.Methods: This research included 470 eligible CAP patients.Serum fasting samples were drawn from patients,and serum survivin was measured by enzyme-linked immunosorbent assay(ELISA).Meanwhile,demographic characteristics and clinical information were collected.The prognosis of CAP patients was tracked.Results: Serum survivin gradually decreased with elevated CAP severity scores.Additionally,the correlative analysis suggested that serum survivin was associated with many clinical characteristics.Furthermore,mixed linear and logistic regression models indicated that serum survivin was negatively associated with severity.After adjusting for confounding factors,logistic regression analyses found that lower serum survivin on admission elevated the risks of mechanical ventilation,vasoactive agent usage,longer hospital stays,ICU admission,and even death during hospitalization.Serum survivin in combination with CAP severity scores elevated the predictive capacities for severity and death in CAP patients compared with a single indicator.The optimal cut-off concentration of serum survivin for severity was 1.72 pg/m L,and had78.9% specificity and 80.2% sensitivity among CAP patients.While,the optimal cut-off content of serum survivin for death was 1.35 pg/m L.The specificity was 86.5%and sensitivity was 80.3%.Conclusion: On admission,there are inverse dose-response associations of serum survivin with severity and poor prognosis in CAP patients,demonstrating that serum survivin may be involved in the pathophysiology process of CAP.Serum survivin may serve as a potential biomarker for disease evaluation and prognosis in CAP patients.