Evaluation value of serum sTREM1 levels combined with modified pediatric early warning score in assessing the condition and prognosis of children with adenovirus pneumonia

GAO Chengfeng; SUN Rui; ZHANG Mingying

doi:10.3969/j.issn.1007-8134.2025.01.012

Abstract：Objective To explore the value of serum soluble triggering receptor expressed on myeloid cells 1(sTREM1)levels combined with the modified pediatric early warning score(MPEWS)in assessing the condition and prognosis of children with adenovirus pneumonia(AdVP).Methods A total of 153 children with AdVP(AdVP group)admitted to Beijing Shunyi District Hospital,Beijing,from January 2021 to July 2024 and 50 healthy children(control group)during the same period were enrolled.The AdVP group was further divided into a severe AdVP group(60 cases)and a mild AdVP group(93 cases)based on the disease severity,and was divided into a poor prognosis group(21 cases)and a good prognosis group(132 cases)based on 28-day outcomes.Serum sTREM1 levels were measured using enzyme-linked immunosorbent assay,and MPEWS scores were calculated.Multivariate unconditional logistic regression was used to analyze the relationship between serum sTREM1 levels,MPEWS scores,and prognosis in children with AdVP.The value of serum sTREM1 levels combined with MPEWS scores in assessing the disease severity and prognosis was evaluated using receiver operating curve analysis.Results Compared with the control group,serum sTREM1 levels were significantly higher in the AdVP group(P＜0.05).In the severe AdVP group,serum sTREM1 levels and MPEWS scores were significantly higher than in the mild AdVP group(P＜0.05).The poor prognosis rate among the 153 children with AdVP was 13.73％(21/153).Compared with the good prognosis group,serum sTREM1 levels and MPEWS scores were significantly higher in the poor prognosis group(P＜0.05).Severe AdVP,high sTREM1 levels,and high MPEWS scores were independent risk factors for poor prognosis in children with AdVP(P＜0.05).The area under the curve(AUC)for serum sTREM1 levels combined with MPEWS scores in evaluating severe AdVP was 0.904,which was greater than the AUCs for serum sTREM1 levels(0.777)and MPEWS scores(0.815)alone(P＜0.05).The AUC for evaluating poor prognosis in children with AdVP was 0.947 for the combined assessment,which was greater than for serum sTREM1 levels(0.811)and MPEWS scores(0.875)alone(P＜0.05).Conclusion Elevated serum sTREM1 levels and MPEWS scores are associated with the disease severity and poor prognosis in children with AdVP.The combination of serum sTREMl levels and MPEWS scores has a high value in assessing the condition and prognosis of children with AdVP.