Predictive Value of Annenxin A1 for Disease Severity and Prognosis in Patients with Community-Acquired Pneumonia
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Data Collection
2.3. Measurement of Serum AnxA1 Level
2.4. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. AnxA1 Level and CAP Etiology
3.3. Case-Control Matching
3.4. Correlation between AnxA1 Level and CAP Severity
3.5. Predictive Value of AnxA1 Level for SCAP in Patients with CAP
3.6. AnxA1 Level in Predicting Prognosis in Patients with SCAP (30-Day Mortality)
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | Non-SCAP (N = 52) | SCAP (N = 53) | p Value |
---|---|---|---|
Sex, male (%) | 40 (76.9) | 27 (50.9) | 0.006 |
Age, years | 57.48 ± 18.93 | 81.13 ± 10.84 | <0.001 |
Underlying disease(s) | |||
Chronic heart failure | 1 (1.9) | 15 (28.3) | <0.001 |
Coronary heart disease | 4 (7.7) | 32 (60.4) | <0.001 |
Diabetes mellitus | 4 (7.7) | 22 (41.5) | <0.001 |
Hypertension | 20 (38.5) | 33 (62.3) | 0.015 |
Cerebrovascular disease | 5 (9.6) | 28 (52.8) | <0.001 |
Chronic liver disease | 0 | 2 (3.8) | 0.495 |
Chronic renal disease | 1 (1.9) | 8 (15.1) | 0.031 |
Chronic obstructive pulmonary disease | 0 | 7 (13.2) | 0.013 |
Physical examination | |||
Tmax, °C | 37.10 ± 0.86 | 37.1 (36.45–37.80) | 0.468 |
Respiratory frequency, breaths/min | 20.40 ± 2.01 | 21 (19.50–27.00) | 0.051 |
Heart rate, beats/min | 83.50 ± 9.87 | 98.98 ± 18.33 | <0.001 |
Confusion | 2 (3.8) | 40 (75.5) | <0.001 |
SBP < 90 mm Hg or DBP ≤ 60 mmHg | 0 | 4 (7.5) | 0.118 |
Laboratory results | |||
WBC (×109/L) | 7.91 (5.85–10.65) | 11.07 (8.73–14.75) | <0.001 |
NEU (×109/L) | 5.15 (3.43–8.91) | 9.22 (7.41–12.76) | <0.001 |
LYM (×109/L) | 1.35 (0.89–1.72) | 0.71(0.41–1.26) | <0.001 |
NLR | 4.26 (2.09–9.07) | 14.74 (6.92–25.41) | <0.001 |
CRP, mg/L | 36.55 (11.44–106.06) | 53.72 (24.69–112.78) | 0.127 |
PCT, μg/L | 0.10 (0.04–0.31) | 0.38 (0.17–3.14) | <0.001 |
Interleukin-6, pg/mL | 4.12 (3.15–7.25) | 10.66 (5.46–16.37) | <0.001 |
Interleukin-8, pg/mL | 11.46(9.1–15.52) | 27.66 (14.59–51.09) | <0.001 |
Interleukin-10, pg/mL | 9.25 (7.25–14.22) | 12.46 (9.34–20.6) | 0.007 |
AnxA1, ng/mL | 240.76 (202.42–378.60) | 441.91 (282.25–780.33) | <0.001 |
Chest X-ray | |||
Multipolar infiltrates | 24 (46.2) | 45 (84.9) | <0.001 |
Pleural effusion | 6 (11.5) | 27 (50.9) | <0.001 |
Pathogen established | |||
Bacteria | 3 (5.8) | 13 (24.5) | |
Fungus | 1 (1.9) | 3 (5.7) | |
Virus | 0 | 0 | |
Atypical pathogen | 0 | 1 (1.9) | |
Mixed pathogen | 0 | 1 (1.9) | |
Unknown | 48 (92.3) | 35 (66.0) | |
CURB-65 score | |||
Score points | 0 (0–1) | 3 (2–3) | <0.001 |
0 | 33 (63.5) | 0 | |
1 | 14 (26.9) | 5 (9.4) | |
2 | 4 (7.7) | 16 (30.2) | |
3 | 1 (1.9) | 26 (49.1) | |
4 | 0 | 5 (9.4) | |
5 | 0 | 1 (1.9) | |
PSI | |||
Score points | 65.83 ± 26.26 | 143.94 ± 32.50 | <0.001 |
≤70 | 30 (57.7) | 0 | |
71–90 | 11 (21.2) | 2 (3.8) | |
91–130 | 11 (21.2) | 17 (32.1) | |
>130 | 0 | 34 (64.2) | |
30-Day mortality | 0 | 13 (24.5) | <0.001 |
Characteristic | Non-SCAP (N = 26) | SCAP (N = 26) | p Value |
---|---|---|---|
Sex, male (%) | 19(73.1) | 15 (57.7) | 0.382 |
Age, years | 72.38 ± 9.21 | 73.62 ± 9.20 | 0.632 |
Laboratory results | |||
Interleukin-6, pg/mL | 6.15 (3.81–9.81) | 10.86 (6.10–14.87) | 0.027 |
Interleukin-8, pg/mL | 11.94 (8.41–17.82) | 33.01 (14.28–64.30) | <0.001 |
Interleukin-10, pg/mL | 11.12 (8.43–16.31) | 11.69 (9.14–15.78) | 0.701 |
AnxA1, ng/mL | 240.76 (208.85–380.44) | 401.62 (271.38–818.93) | <0.001 |
CURB-65 score | 1 (0–1) | 3 (2–3) | <0.001 |
PSI | 72.50 (63.00–91.25) | 134.50 (110.75–156.00) | <0.001 |
Hospital Mortality | 0 | 9 (34.6) | <0.001 |
Univariate Analysis | Multivariate Analysis | |||
---|---|---|---|---|
Variable | HR (95% CI) | p Value | HR (95% CI) | p Value |
Male | 0.502 (0.157–1.610) | 0.247 | ||
Age, years | 1.015 (0.956–1.078) | 0.624 | ||
WBC (×109/L) | 1.128 (0.995–1.278) | 0.059 | ||
NEU (×109/L) | 1.139 (1.003–1.294) | 0.045 | ||
LYM (×109/L) | 0.633 (0.295–1.359) | 0.241 | ||
NLR | 1.067 (1.008–1.129) | 0.026 | ||
IL-6, pg/mL | 1.020 (0.981–1.060) | 0.328 | ||
IL-8, pg/mL | 1.074 (1.022–1.128) | 0.005 | ||
IL-10, pg/mL | 0.991 (0.941–1.045) | 0.746 | ||
AnxA1, ng/mL | 1.005 (1.001–1.008) | 0.005 | ||
PSI score | 1.111 (1.047–1.179) | <0.001 | 1.108 (1.028–1.195) | 0.008 |
CURB-65 | 10.883 (3.231–36.659) | <0.001 | 7.677 (1.003–58.746) | 0.050 |
Variable | AUC | 95% CI | Sensitivity (%) | Specificity (%) | Threshold | p Value | |
---|---|---|---|---|---|---|---|
Lower Limit | Upper Limit | ||||||
CRP, mg/L | 0.558 | 0.398 | 0.719 | 73.1% | 44.0% | >25.67 | 0.474 |
PCT, μg/L | 0.740 | 0.602 | 0.878 | 96.2% | 48.0% | >0.085 | 0.003 |
IL-6, pg/mL | 0.675 | 0.526 | 0.825 | 57.7% | 80.0% | >10.05 | 0.032 |
IL-8, pg/mL | 0.823 | 0.708 | 0.938 | 65.4% | 88.0% | >23.85 | <0.001 |
IL-10, pg/mL | 0.512 | 0.351 | 0.674 | 50.0% | 64.0% | >12.25 | 0.880 |
AnxA1, ng/mL | 0.768 | 0.638 | 0.898 | 84.6% | 64.0% | >254.13 | 0.001 |
CURB-65 | 0.920 | 0.850 | 0.990 | 84.6% | 84.0% | >1.5 | <0.001 |
PSI score | 0.955 | 0.906 | 1.000 | 92.3% | 88.0% | >101 | <0.001 |
CURB-65 + AnxA1 | 0.938 | 0.878 | 0.999 | 92.3% | 84.0% | >-0.32 | <0.001 |
PSI + AnxA1 | 0.922 | 0.838 | 1.000 | 88.5% | 92.0% | >5.22 | <0.001 |
Variable | AUC | 95% CI | Sensitivity (%) | Specificity (%) | Threshold | p Value | |
---|---|---|---|---|---|---|---|
Lower limit | Upper limit | ||||||
IL-6, pg/mL | 0.685 | 0.508 | 0.861 | 66.7% | 67.4% | >10.05 | 0.084 |
IL-8, pg/mL | 0.837 | 0.693 | 0.981 | 77.8% | 88.4% | >41.04 | 0.002 |
IL-10, pg/mL | 0.491 | 0.310 | 0.672 | 77.8% | 39.5% | >9.77 | 0.933 |
AnxA1, ng/mL | 0.809 | 0.637 | 0.981 | 66.7% | 93.0% | >670.84 | 0.004 |
CURB-65 | 0.685 | 0.523 | 0.847 | 77.8% | 55.8% | >1.5 | 0.084 |
PSI score | 0.933 | 0.863 | 1.000 | 1 | 76.7% | >114.5 | <0.001 |
Univariate Analysis | Multivariate Analysis | |||
---|---|---|---|---|
Variable | HR (95% CI) | p Value | HR (95% CI) | p Value |
IL-6, pg/mL | 1.013 (1.004–1.022) | 0.006 | 1.013 (1.003–1.022) | 0.006 |
IL-8, pg/mL | 1.008 (0.995–1.021) | 0.247 | ||
IL-10, pg/mL | 0.918 (0.785–1.074) | 0.287 | ||
AnxA1, ng/mL | 1.002 (1.000–1.003) | 0.085 | ||
PSI score | 1.034 (1.014–1.054) | 0.001 | 1.037 (1.015–1.060) | 0.008 |
CURB-65 | 1.116 (0.626–1.988) | 0.711 |
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Gu, M.; Han, X.; Liu, X.; Sui, F.; Zhang, Q.; Pan, S. Predictive Value of Annenxin A1 for Disease Severity and Prognosis in Patients with Community-Acquired Pneumonia. Diagnostics 2023, 13, 396. https://doi.org/10.3390/diagnostics13030396
Gu M, Han X, Liu X, Sui F, Zhang Q, Pan S. Predictive Value of Annenxin A1 for Disease Severity and Prognosis in Patients with Community-Acquired Pneumonia. Diagnostics. 2023; 13(3):396. https://doi.org/10.3390/diagnostics13030396
Chicago/Turabian StyleGu, Minghao, Xiudi Han, Xuedong Liu, Fengxiang Sui, Quansan Zhang, and Shengqi Pan. 2023. "Predictive Value of Annenxin A1 for Disease Severity and Prognosis in Patients with Community-Acquired Pneumonia" Diagnostics 13, no. 3: 396. https://doi.org/10.3390/diagnostics13030396