Correlational Analysis of Immune-Inflammatory Markers with the Clinical Outcomes of Severe Pneumonia

Corresponding author: gaoweiwei, 13598832393@163.com

DOI: 10.12201/bmr.202409.00062

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  Abstract: 【】 Objective To compare and analyze the predictive value of different immune-inflammatory parameters for adverse outcomes in Severe Community-Acquired Pneumonia (SCAP) and to propose new indicators. Methods The retrospective analysis was conducted on 196 severe pneumonia patients admitted to the Second Affiliated Hospital of Zhengzhou University from May 2021 to April 2024. Patients were divided into an good prognosis group and a poor prognosis group based on the 28-day hospital outcome. Laboratory indicators were collected and inflammatory indices such as the neutrophil-to-lymphocyte ratio (NLR) and the ratio of NLR to hemoglobin (NLR/HB) were calculated. Logistic regression analysis was used to identify independent risk factors for poor prognosis in SCAP and to construct a regression model. The diagnostic efficacy of NLR/HB for adverse outcomes in SCAP was evaluated using the receiver operating characteristic (area under curve, AUC) curve. Results Showed that the NLR during hospitalization in the good prognosis group was higher than that in the poor prognosis group. The hemoglobin (HB) in the good prognosis group was higher than that in the poor prognosis group, and the HB value of admitted patients generally showed a downward trend. The platelet (PLT) count in the good prognosis group showed an overall upward trend during hospitalization, while the poor prognosis group showed a downward trend. The calculation formula for NLR/HB is proposed as NLR/HB = NLR * 100 / HB. NLR/HB at day 7 showed the most stable significance in multi-model multi-factor logistic regression analysis (P < 0.001). The indicators with differences were included in the multi-factor logistic regression model. The results showed that NLR/HB at day 7, D-dimer, and invasive mechanical ventilation were risk factors for poor prognosis (P < 0.05), and the platelet count at day 7 was a protective factor for poor prognosis (P < 0.05). The ROC curve analysis showed that NLR/HB at day 7 and platelet count at day 7 were 0.786 (95% CI = 0.722~0.851, P < 0.001) and 0.749 (95% CI = 0.681~0.816, P < 0.001), respectively.? Conclusion Dynamic monitoring of blood routine is very necessary in clinical practice, and NLR/HB is expected to become an effective indicator for judging the poor prognosis of severe pneumonia patients.

  Key words: Severe Pneumonia; Neutrophils; Lymphocytes; Platelets; Hemoglobin

  Submit time: 27 September 2024

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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