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| Evaluation value of serum HMGB1 combined with EVLWI in the prognosis of elderly patients with severe pneumonia complicated with acute respiratory distress syndrome#br# |
| LIN Yufeng1 MI Qing2 LIN Ding1 QI Chunhua1 ZHOU Yufa1 |
1.The Second Department of Respiratory Medicine, Jinan People’s Hospital, Shandong Province, Jinan 271199, China;
2.the Second Department of Neurology, Jinan People’s Hospital, Shandong Province, Jinan 271199, China |
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Abstract Objective To investigate the predictive value of serum highy mobility group protein B1 (HMGB1) combined with extravascular lung water index (EVLWI) on the prognosis of elderly patients with severe pneumonia complicated with acute respiratory distress syndrome (ARDS). Methods The clinical data of 125 elderly patients with severe pneumonia complicated with ARDS in Jinan People’s Hospital from January 2018 to June 2020 were analyzed retrospectively. They were divided into death group (54 cases) and survival group (71 cases) according to the survival condition. The clinical data, HGMB1, and EVLWI of the two groups were compared. The prognostic factors of elderly patients with severe pneumonia complicated with ARDS were analyzed by logistic regression. Receiver operating characteristic curve was used to analyze the prognostic value of HMGB1 combined with EVLWI in elderly patients with severe pneumonia complicated with ARDS. Results The levels of serum HMGB1, EVLWI, and sepsis-related organ failure assessment score in the death group were higher than those in the survival group, oxygenation index was lower than that of the survival group, and the differences were statistically significant (P ＜ 0.05). Multivariate analysis showed that high HMGB1 level and high EVLWI index were independent risk factors for prognosis of elderly patients with severe pneumonia complicated with ARDS (OR ＞ 1, P ＜ 0.05). HMGB1 and EVLWI alone and in combination had certain diagnostic value for the prognosis of elderly patients with severe pneumonia complicated with ARDS (AUC ＞ 0.5, P ＜ 0.05). The area under the curve of HMGB1 combined with EVLWI in predicting the prognosis of elderly patients with severe pneumonia complicated with ARDS was 0.904, which was higher than those of HMGB1 and EVLWI alone (P ＜ 0.05). Conclusion High levels of HMGB1 and EVLWI are associated with poor prognosis in elderly patients with severe pneumonia complicated with ARDS, and combination of HMGB1 and EVLWI can improve the prognostic efficacy of patients.
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