Evaluation of MCP-1 combined with CREWS for poor prognosis in patients with AECOPD

doi:10.3969/j.issn.1673-8640.2022.010.005

Abstract

Abstract:

Objective To investigate the effect of monocyte chemotactic protein-1（MCP-1） and chronic respiratory early warning score（CREWS） on predicting acute exacerbations of chronic obstructive pulmonary disease（AECOPD） poor prognosis. Methods A total of 260 patients with AECOPD were enrolled. MCP-1 level at admission was determined，and CREWS was performed simultaneously. According to the prognosis during hospitalization and within 1 year after discharge，they were classified into poor prognosis group and good prognosis group. Multivariate Cox regression analysis was used to evaluate the risk factors for poor prognosis in patients with AECOPD. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of each index in predicting poor prognosis（readmission or death） in patients with AECOPD. Kaplan-Meier survival curve was used to evaluate the survival of AECOPD patients. Results The proportion of pulmonary function grade Ⅲ-Ⅳ，MCP-1 level and CREWS in poor prognosis group were higher than those in good prognosis group（P<0.05），but there was no statistical significance in the other indicators between the 2 groups（P>0.05）. Multivariate Cox regression analysis showed that pulmonary function grade，MCP-1 and CREWS were risk factors for poor prognosis in patients with AECOPD [odds ratios（OR） were 3.045，1.683 and 1.423，respectively，95% confidence intervals（CI） were 1.467-4.638，1.132-4.248 and 1.138-1.865，respectively]. ROC curve analysis showed that the areas under curves（AUC） of MCP-1 and CREWS single determinations and combined determination for predicting poor prognosis（readmission or death） of AECOPD patients were 0.823，0.881 and 0.912，respectively，and the optimal cut-off values of MCP-1 and CREWS were 42.19 ng/L，6 and 0.48，respectively. AECOPD patients with CREWS<6 and MCP-1<42.19 ng/L were classified into low-risk group（78 cases），and AECOPD patients with CREWS≥6 and MCP-1≥42.19 ng/L were classified into high-risk group（87 cases），and the remaining AECOPD patients were classified into medium-risk group（95 cases）. The event free survival rate in high-risk group was lower than those in low-risk and medium-risk groups（P<0.001）. Conclusions MCP-1 level and CREWS have certain predictive value for poor prognosis of AECOPD patients.

Key words: Monocyte chemotactic protein-1, Chronic respiratory early warning score, Acute exacerbation of chronic obstructive pulmonary disease

WANG Xiaoqing, PENG Xuemei, LAN Meifeng, PAN Min. Evaluation of MCP-1 combined with CREWS for poor prognosis in patients with AECOPD[J]. Laboratory Medicine, 2022, 37(10): 934-938.

Figures/Tables 5

References 17

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组别	例数	年龄/岁	性别		病程/年	BMI/ （kg/m²）
组别	例数	年龄/岁	男/[例（%）]	女/[例（%）]	病程/年	BMI/ （kg/m²）
预后不良组	128	64.21 ±9.01	58（45.31）	70（54.69）	14.82±9.46	21.29±4.01
预后良好组	132	63.45±8.39	66（50.00）	66（50.00）	13.28±8.34	21.74±3.82
统计值		0.704	1.558		1.393	0.927
P值		0.482	0.212		0.165	0.355

组别	例数	年龄/岁	性别		病程/年	BMI/ （kg/m²）
组别	例数	年龄/岁	男/[例（%）]	女/[例（%）]	病程/年	BMI/ （kg/m²）
预后不良组	128	64.21 ±9.01	58（45.31）	70（54.69）	14.82±9.46	21.29±4.01
预后良好组	132	63.45±8.39	66（50.00）	66（50.00）	13.28±8.34	21.74±3.82
统计值		0.704	1.558		1.393	0.927
P值		0.482	0.212		0.165	0.355

项目	β值	标准误	Wald值	P值	OR值（95%CI）
肺功能分级	1.793	0.632	7.724	0.003	3.045（1.467~4.638）
MCP-1	0.521	0.684	0.580	0.521	1.683（1.132~4.248）
CREWS	2.637	0.816	5.648	0.021	1.423（1.138~1.865）

项目	β值	标准误	Wald值	P值	OR值（95%CI）
肺功能分级	1.793	0.632	7.724	0.003	3.045（1.467~4.638）
MCP-1	0.521	0.684	0.580	0.521	1.683（1.132~4.248）
CREWS	2.637	0.816	5.648	0.021	1.423（1.138~1.865）

项目	AUC（95%CI）	最佳临界值	敏感性/%	特异性/%	P值
CREWS	0.881（0.834~0.929）	6分	77.00	88.90	<0.001
MCP-1	0.823（0.883~0.976）	42.19 ng/L	83.32	84.53	<0.001
联合检测	0.912（0.654~0.874）	0.48	93.45	90.54	<0.001