Chest CT combined with serological indexes can predict the prognosis of patients with severe pneumonia

YIN Jianfei; GONG Lingyan; WANG Weiwei

doi:10.12122/j.issn.1674-4500.2025.11.13

Abstract：Objective To investigate the prognostic value of chest CT combined with serological indexes[hypersensitive C-reactive protein(hs-CRP),D-dimer(D-D),procalcitonin(PCT)]in patients with severe pneumonia.Methods A total of 80 patients with severe pneumonia and 60 patients with common pneumonia in the Sixth People's Hospital of Nantong were enrolled as severe group and common group from November 2020 to August 2024,respectively.All patients underwent chest CT plain scan,and levels of hs-CRP,D-D and PCT were detected.According to 28d survival,patients in severe group were divided into death group(n=29)and survival group(n=51).CT scores,hs-CRP,D-D and PCT in different groups were compared,and their prognostic value in severe patients was evaluated.Results CT score,levels of hs-CRP,D-D and PCT in severe group were higher than those in common group(P<0.05).APACHE II score at admission,proportions of infection strains≥2 kinds,disorder of consciousness,organ dysfunction≥3,septic shock and mechanical ventilation,CT score,levels of hs-CRP,D-D and PCT in death group were higher than those in survival group(P<0.05).High APACHE II score at admission,organ dysfunction≥3 and high CT score were independent risk factors of 28 d prognosis(death)in patients with severe pneumonia(P<0.05).The area under the curve(AUC)values of CT score,hs-CRP,D-D and PCT for predicting prognosis of patients with severe pneumonia were 0.714(95%CI:0.592-0.836),0.686(95%CI:0.564-0.808),0.727(95%CI:0.607-0.847)and 0.734(95%CI:0.619-0.850),respectively.AUC of combined detection with the above indexes was 0.886(95%CI:0.809-0.964),greater than that of single index(P<0.05).Conclusion Chest CT combined with hs-CRP,D-D and PCT can effectively predict prognosis and guide the formulation of clinical protocols in patients with severe pneumonia.