Serum Krebs von den Lungen-6 is associated with in-Hospital mortality of patients with severe Community-Acquired Pneumonia: A retrospective cohort study

被引:1
作者
Lu, Rongli [1 ,2 ,3 ,4 ,5 ]
Yang, Hang [1 ,2 ,3 ,4 ,5 ]
Peng, Wenzhong [1 ,2 ,3 ,4 ,5 ]
Tang, Haiyun [6 ]
Li, Yi [1 ,2 ,3 ,4 ,5 ]
Lin, Fengyu [1 ,2 ,3 ,4 ,5 ]
Zhou, Aiyuan [1 ,2 ,3 ,4 ,5 ]
Pan, Pinhua [1 ,2 ,3 ,4 ,5 ]
机构
[1] Cent South Univ, Branch Natl Clin Res Ctr Resp Dis, Dept Resp Med, Natl Key Clin Specialty,Xiangya Hosp, Changsha 410008, Hunan, Peoples R China
[2] Cent South Univ, Xiangya Hosp, Ctr Resp Med, Xiangya Rd 87, Changsha 410008, Hunan, Peoples R China
[3] Clin Res Ctr Resp Dis Hunan Prov, Changsha 410008, Hunan, Peoples R China
[4] Hunan Engn Res Ctr Intelligent Diag & Treatment Re, Changsha 410008, Hunan, Peoples R China
[5] Xiangya Hosp, Natl Clin Res Ctr Geriatr Disorders, Changsha 410008, Hunan, Peoples R China
[6] Cent South Univ, Xiangya Hosp, Dept Radiol, Changsha, Hunan, Peoples R China
基金
中国博士后科学基金; 中国国家自然科学基金;
关键词
SKL-6; SCAP; In-hospital mortality; Pneumonia; Biomarker; VENTILATOR-ASSOCIATED PNEUMONIA; INFECTIOUS-DISEASES-SOCIETY; STREPTOCOCCUS-PNEUMONIAE; PULMONARY-FIBROSIS; KL-6; LEVELS; GUIDELINES; DIAGNOSIS; MANAGEMENT; INDICATOR; ADULTS;
D O I
10.1016/j.cca.2023.117524
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Background: Currently, no ideal biomarker can accurately stratify the risk of patients with severe community acquired pneumonia (SCAP). This study aimed to evaluate the role of serum Krebs von den Lungen-6 (sKL-6) in predicting in-hospital mortality in adults with SCAP.Methods: In this retrospective cohort study, 249 severe pneumonia adult patients were recruited between 6 May 2021 to 30 April 2023 in Xiangya Hospital of Central South University. The sKL-6 level within 48 h of admission was measured, and the primary outcome assessed was in-hospital mortality. Multivariable logistic regression analysis was performed to calculate adjusted odds ratios (OR) with 95% confidence intervals (CI). Survival curves were plotted and subgroup analyses were conducted, stratified by relevant covariates.Results: A total of 249 patients were included in the study,with 124 patients having normal sKL-6 levels, and 125 patients having abnormal sKL-6 levels. The overall in-hospital mortality rate was 28.9% (72 out of 249 patients). Univariate and multivariate logistic regression analysis revealed that the patients with abnormal sKL-6 levels had a higher risk of in-hospital mortality compared to those with normal sKL-6 levels, both in the total SCAP patient population (OR: 5.38, 95%CI: 2.41-12.01, P < 0.001) and the non-COVID-19 SCAP patients subgroup (OR: 8.12, 95%CI: 3.16-20.84, P < 0.001). Subgroup and interaction analyses confirmed the stability of the relationship between sKL-6 levels and in-hospital mortality(P for interaction > 0.05). Kaplan-Meier survival curves showed that patients with abnormal sKL-6 levels had a higher in-hospital mortality rate than those with normal sKL-6 levels (P < 0.05). However, the results of restricted cubic spline plots(RCS) analysis demonstrated a nonlinear association between sKL-6 levels (as a continuous variable) and in-hospital mortality in patients with SCAP. Similar results were observed in non-COVID-19 SCAP patients. Furthermore, the receiver operating characteristic curve (ROC) analysis revealed that sKL-6 had superior predictive performance compared to existing biomarkers (e.g., APACHE-II, SOFA, BUN/Cr, PCT, and D-dimer) for in-hospital mortality in non-COVID-19 SCAP patients.Conclusion: sKL-6 is a practical and useful biomarker for predicting in-hospital mortality in patients with SCAP.
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页数:10
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