Abstract:

Objective To investigate the effects of procalcitonin (PCT), C-reaction protein (CRP), and D-dimer on the evaluation of prognosis of patients with severe pneumonia. Methods Clinical data of 83 patients with severe pneumonia were collected and the patients were divided into the survivor group and non-survivor group according to the prognosis. Clinical characteristics, coexisting diseases, acute physiological and chronic health evaluationⅡ (APACHEⅡ) score, mechanical ventilation, and pathogens of patients were retrospectively analyzed. The initial and maximum values of PCT, CRP, and D-dimer of two groups were compared. The increasing trend of PCT, CRP, and D-dimer and its correlation with the prognosis were analyzed. The receiver operating characteristic (ROC) curve was adopted to analyze the effects of initial and maximum values of PCT, CRP, and D-dimer on the prediction of mortality. Results The initial and maximum values of PCT, CRP, and D-dimer of the non-survivor group were higher than those of the survivor group. The differences of values were statistically significant (P<0.01) except for the initial value of D-dimer. The increase of PCT, CRP, and D-dimer was correlated to the mortality and the odds ratios (OR) (95%CI) were 3.5 (1.4-8.6), 6.9 (2.6-18.2), and 11.5 (3.1-43.2)(P<0.01), respectively. Areas under the ROC curve of maximum PCT, scores of APACHEⅡ, maximum CRP, and maximum D-dimer for the prediction of mortality were 0.87, 0.86, 0.81, and 0.79. Conclusion PCT, CRP, and D-dimer can reflect the severity of pneumonia. The increase of PCT, CRP, and D-dimer suggests poor prognosis. Maximum PCT is a satisfactory indicator for evaluating the prognosis.

Key words: severe pneumonia, procalcitonin, C-reactive protein, D-dimer, prognosis