Analysis Of The Mortality Prediction Of Platelet Associated Parameter Test Combined With PSI Score In Patients With Severe Pneumonia

Objective: Pneumonia mainly refers to the inflammation of lung parenchyma and interstitial lung caused by pathogenic microorganisms such as bacteria,viruses or fungi and various physical and chemical factors.Pneumonia can lead to alveolar and interstitial inflammation,pulmonary interstitial inflammation,lung parenchyma filled with exudate,ventilation and diffuse dysfunction,which in turn causes patients to have difficulty breathing.The degree of local inflammation,the spread of lung inflammation,and the degree of systemic inflammatory response all determine the severity of pneumonia.When pneumonia patients have severe hypoxemia and other acute respiratory failure,or hypotension,shock and other circulatory failure,it can be considered as severe pneumonia.The latter has a high mortality rate.The purpose of this study is to investigate the predictive effect of platelet-related parameter detection combined with pneumonia severity index(PSI)score on 28-day mortality in patients with severe pneumonia.Methods: A retrospective study was conducted on the clinical data of 256 patients with pneumonia admitted from February 2015 to May 2018,including 132 cases of non-severe pneumonia and non-severe pneumonia group.124 cases of severe pneumonia were recorded as severe pneumonia.Platelet-related parameters such as platelet count(PLT),mean platelet volume(MPV),platelet large cell ratio(P-LCR),and platelet volume distribution width(PDW)were measured within 2 hours after admission,and the differences between the two groups were compared.PSI scores were obtained in the severe pneumonia group,and the receiver operating characteristic curve(ROC)was plotted against the platelet-related parameters and PSI scores of survivors and deaths inthe pneumonitis group for 28 days.The area under the curve(AUC)was used to evaluate patients with severe pneumonia.The role of death prediction.Results: The results showed that the PLT in the severe pneumonia group was higher than that in the non-severe pneumonia group(P<0.05),while the PDW,MPV and P-LCR were lower than those in the non-severe pneumonia group(P<0.05).The PLT and the death patients in the severe pneumonia group within 28 days.PSI scores were higher than those in survivors(P<0.05),PDW,MPV and P-LCR were lower than those in survivors(P<0.05);PDW,MPV,PSI score,PLT and P-LCR predicted severe pneumonia death within 28 days.The optimal cut-off points were 6.25 fl,5.00 fl,135.50,340.00×109/L and 11.00%,respectively.AUC were 0.811,0.802,0.765,0.717,0.639,respectively.Platelet-related parameters combined with PSI score predicted death within28 days of severe pneumonia.The sensitivity,specificity and AUC were the highest,which were 96.67%,98.94% and 0.939,respectively.Conclusion: Compared with non-severe pneumonia,The PLT,PDW,MPV and P-LCR were significantly abnormal in patients with severe pneumonia,and platelet-related parameters combined with PSI scores had higher predictive power for death within 28 days.