Clinical values of CPIS score,miR-127 and miR-146a in diagnosis of prognosis of elderly patients with severe pneumonia
OBJECTIVE To explore the distribution of pathogens and analyze the values of clinical pulmonary infec-tion score(CPIS),micro ribonucleic acid-127(miR-127)and micro ribonucleic acid-146a(miR-146a)in diagnosis of poor prognosis of the elderly patients with severe pneumonia(SP).METHODS A total of 485 elderly patients with SP who were treated in Dongfeng General Hospital of Sinopharm Affiliated to Hubei University of Medicine from Jan 2021 to Mar 2023 were enrolled in the study,45 of whom died after the treatment for 1 month and were assigned as the poor prognosis group,and 440 survived after the treatment for 1 month and were assigned as the favorable prognosis group.The clinical data and distribution of pathogens causing infections were observed and compared between the two groups of patients.The values of the CPIS,miR-127 and miR-146a in diagnosis of the poor prognosis of the elderly patients with SP were analyzed by means of receiver operating characteristic(ROC)curve.RESULTS The patients of the poor prognosis group were significantly older than those of the favorable prognosis group(P＜0.05).The proportion of patients with no less than 3 organs involved,number of times of mechanical ventilation and catheter indwelling were significantly increased(P＜0.05);the CPIS was significantly increased(P＜0.05).Totally 659 strains of pathogens were isolated,Pseudomonas aeruginosa and Acinetobacter baumannii were the predominant species of pathogens.The levels of miR-127 and miR-146a of the poor prognosis group were significantly higher than those of the favorable prognosis group(P＜0.05).The area under curve(AUC)of the joint detection of CPIS,miR-127 and miR-146 was 0.916 in diagnosis of the poor prognosis of the elderly patients with SP,with the sensitivity 82.22％,the specificity 87.27％;the diagnostic value of the joint detection was significantly higher(P＜0.05).CONCLUSION P.aeruginosa and A.baumannii are dominant a-mong the pathogens causing the infections in the elderly patients with SP.The CPIS,serum miR-127 and miR-146a are closely associated with the prognosis of the patients,and the joint detection of the above indexes has high value in diagnosis of the prognosis.
Severe pneumoniaThe elderlyPathogenClinical pulmonary infection scoreMicro ribonucleic acid-127Micro ribonucleic acid-146aDiagnostic value
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