Abstract
Objective: To explore the values of PCT and STREM-1 combined with clinical pulmonary infection score (CPIS) for evaluating ventilator-associated pneumonia (VAP) in elderly patients.
Methods: A total of 120 eligible patients were selected as VAP group, and 60 other patients without VAP were selected as control group. According to APACHE II scores, VAP group was divided into low-, medium-, and high-risk groups. The correlations of PCT, STREM-1, and CPIS with APACHE II score were analyzed. The values of PCT and STREM-1 combined with CPIS for evaluating prognosis were analyzed using ROC curves.
Results: In the VAP group, serum PCT and STREM-1 levels and CPIS after mechanical ventilation significantly exceeded those of the control group and before mechanical ventilation (P<0.05). These values were higher in the high-risk group than in medium- and low-risk groups (P<0.05). They were positively correlated with APACHE II score (P<0.001). These values of the death group were significantly higher than those of the survival group 1, 3, 5, and 7 d after treatment (P<0.05). AUC of PCT and STREM-1 combined with CPIS for assessing prognosis was 0.892 (P<0.001).
Conclusions: Serum PCT and STREM-1 levels and CPIS significantly increase in elderly patients with VAP, which rise with aggravation. Their combination has higher values for prognostic evaluation.