Predictive efficacy of serum procalcitonin,copeptin,and cholinesterase for the prognosis of patients with craniocerebral injury complicated by pulmonary infections after mechanical ventilation
Objective To explore the relationship between levels of serum procalcitonin(PCT),copeptin and cholinesterase(CHE)and the prognosis of patients with craniocerebral injury complicated by pulmonary infections after mechanical ventilation.Methods The 70 patients with craniocerebral injury complicated by pulmonary infections who were admitted to Changning People's Hospital for mechanical ventilation from December 2020 to December 2023 were selected as the infected group,and 82 patients with only craniocerebral injury in the hospital during the same period were included in the uninfected group.Patients in the infected group were divided into the survival group(n=48)and the death group(n=22)according to the 28-day survival status.The levels of serum PCT,copeptin and CHE were compared among the groups.Univariate analysis and multivariate Logistic regression analysis were performed to identify the risk factors affecting the death of patients with craniocerebral injury complicated by pulmonary infections after mechanical ventilation.Receiver operating characteristic(ROC)curve was plotted to assess the predictive values of serum PCT,copeptin and CHE for the death of patients with craniocerebral injury complicated by pulmonary infections after mechanical ventilation.Results The levels of serum PCT and copeptin in the infected group were higher than those in the uninfected group(P<0.05),while the level of CHE in the infected group was lower than that in the uninfected group(P<0.05).There were statistically significant differences in the forced expiratory volume in one second/forced vital capacity(FEV1/FVC),serum levels of PCT,copeptin,and CHE,the Glasgow coma scale(GCS)score,the clinical pulmonary infection score(CPIS)and the Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱ score between the survival group and death group(P<0.05).Multivariate Logistic regression analysis showed that higher levels of serum PCT[(O^R)=1.531(95％ CI:1.059,2.213)],copeptin[(O^R)=2.132(95％ CI:1.161,3.914)],and CHE[(O^R)=3.251(95％ CI:1.383,7.641)],and higher CPIS scores[(O^R)=4.860(95％ CI:2.210,10.686)]and APACHE Ⅱ scores[(O^R)=2.901(95％ CI:1.327,6.341)]were independent risk factors affecting the death of patients with craniocerebral injury complicated by pulmonary infections after mechanical ventilation(P<0.05).ROC curve analysis indicated that the sensitivities of PCT,copeptin and CHE in predicting the death of patients with craniocerebral injury complicated by pulmonary infections after mechanical ventilation were 68.20％,68.20％ and 77.30％,with the specificities being 66.70％,64.60％ and 70.80％,and the areas under the curves(AUC)being 0.754,0.749 and 0.853.The sensitivity,specificity and AUC of the combined prediction of the three indicators were 90.90％,62.50％ and 0.904,respectively,indicating a high predictive value.Conclusion The combined detection of serum levels of PCT,copeptin and CHE has a good predictive value for the prognosis of patients with craniocerebral injury complicated by pulmonary infections after mechanical ventilation..
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