The Evaluation Of Severity And Prognosis Of Pneumonia By C-reactive Protein To Albumin Ratio

Background:Lower respiratory tract infection rank fourth among the top ten causes of death worldwide.Lower respiratory tract infections include infections in the trachea,bronchi,bronchiole,and lung tissue.Pneumonia is a common clinical respiratory disease.With the influence of factors such as population aging,antimicrobial abuse and environmental degradation,the incidence rate has been increasing year by year.If not treated in time,the disease progresses worse,and it can develop into severe pneumonia.Severe pneumonia(SP)refers to the deterioration of lung inflammation to a certain extent,causing organ dysfunction or even life-threatening.It has the characteristics of rapid development,multiple complications and poor prognosis.Although there have been great progress in the detection of etiology,selection of new antibiotics and life support technology,the mortality rate of severe pneumonia is still high.Early prediction and correct management of severe pneumonia are conducive to reducing mortality,shortening hospital stays and reducing medical expenses.Therefore,it is of great significance to look for early indicators to predict the severity of pneumonia and the prognosis of pneumonia.Objective:To explore the value of C-reactive protein to albumin ratio in evaluating the severity and the prognosis of pneumonia and to provide help for the assessment of the severity and the prognosis of pneumonia.Methods:According to the inclusion criteria,100 patients with severe pneumonia and 224patients with general pneumonia who were hospitalized in the Second Affiliated Hospital of Nanchang University from November 2017 to November 2019 were selected as the study objects,which were divided into the severe pneumonia group(100 patients with severe pneumonia)and the general pneumonia group(224 patients with general pneumonia).according to the 28 natural survival conditions of severe pneumonia were divided into the death group(55 patients)and the survival group(45patients).The age,gender,hypertension history,diabetes history,chronic obstructive pulmonary disease history,CRP and albumin numerical laboratory indicators within24 hours after admission or diagnose pneumonia were collected.SPSS 25.0 software was used for statistical analysis.The measurement data conforming to the normal distribution was expressed as mean�standard deviation(x�S);The t test was used for comparison of mean between two independent samples;?~2 test was used for counting data;multivariate logistic regression was used to analyze the risk factors of pneumonia severity and death rate of severe pneumonia,and ROC curve was used to analyze the evaluation value of C-reactive protein to albumin ratio for the severity and prognosis of pneumonia.Results:(1)General data:The severe pneumonia group is older than the ordinary pneumonia group,and the death group is older than the survival group.There was no significant difference in gender composition,diabetes mellitus,hypertension and chronic obstructive pulmonary disease(P>0.05).Test result:The CRP and CRP/Alb ratio in the severe pneumonia group were significantly higher than those in the general pneumonia group,and albumin was lower than those in the general pneumonia group,and the differences were statistically significant(P<0.05).Among the patients in the severe pneumonia group,the death group The CRP and CRP/Alb ratio in the death group were significantly higher than those in the survival group,and the albumin was lower than those in the survival group,and the differences were statistically significant(P<0.05).(2)The Multivariate logistic regression analysis of factors affecting the severity of patients with pneumonia indicated that CRP(OR=1.27;95%CI:1.11~1.48)increased,Alb(OR=0.51;95%CI:0.27~0.79)decreased,and increased CRP/Alb ratio(OR=2.62;95%CI:0.26~6.40)is a risk factor for the aggravation of pneumonia patients;age difference is not statistically significant for the results of the two groups;The Multivariate logistic regression analysis of factors affecting the prognosis of patients with pneumonia suggest that decreased Alb(OR=0.82;95%CI:0.70~0.94)and increased CRP/Alb ratio(OR=1.75;95%CI:1.06~3.11)are independent risks of poor prognosis in patients with pneumonia factors.The differences were statistically significant(P<0.05).(3)In the prediction of the severity of disease in patients with pneumonia,when the CRP/Alb ratio is 1.52 as the optimal cut-off,the area under the ROC curve of the CRP/Alb ratio is the largest(0.89),and the corresponding sensitivity and specificity are 91.01%and 75.43%;In predicting the prognostic effect of patients with pneumonia,when the CRP/Alb ratio is 2.28 as the optimal limit,the area under the ROC curve of the CRP/Alb ratio is the largest(0.85),and the corresponding sensitivity and specificity are 79.04%and 81.92%respectively.Conclusion:(1)The C-reactive protein?CRP/Alb ratio and albumin are independent risk factors for the severity of pneumonia.(2)The CRP/Alb ratio and albumin is an independent prognostic risk factor for severe pneumonia.(3)The CRP/Alb ratio is better than the single C-reactive protein an albumin in predicting the severity and prognosis of severe pneumonia.