Analysis of the Value of Urea Nitrogen/Albumin Ratio and CURB-65 Score Combined with Emergency Infection in Predicting Poor Prognosis of Pa-tients with Severe Pneumonia

YANG Bowen; YUAN Meng; HAN Cailing; GUO Zhanmin

doi:10.3969/j.issn.1002-3429.2024.03.014

Abstract：Objective To investigate the value of urea nitrogen/albumin ratio(UAR)and confusion,urea nitrogen,respiratory rate,blood pressure and age≥65 years(CURB-65)scoring system for community acquired pneumonia(CAP)combined with three items of emergency infection[hypersensitive C-reactive protein(hs-CRP),procalcitonin(PCT)and in-terleukin-6(IL-6)]in predicting poor prognosis in patients with severe pneumonia.Methods A total of 131 patients with severe pneumonia admitted to the Emergency Department of our hospital from August 2019 to August 2022 were selected,and divided into good prognosis group(n =34)and poor prognosis group(n =97)based on 30-day follow-up.General data and the levels of UAR,CURB-65 scores,hs-CRP,PCT and IL-6 at admission and at 1 d,3 d and 7 d after admission were com-pared between the two groups.The value of the above indexes alone and in combination in predicting the poor prognosis of se-vere pneumonia was analyzed.Results The proportions of age,comorbid diabetes mellitus,coronary artery disease,and chronic obstructive pulmonary disease(COPD)was higher in the poor prognosis group than in the good prognosis group,while the oxygenation index was lower than that in the good prognosis group(P<0.05,P<0.01).The levels of UAR,CURB-65 score,hs-CRP,PCT and IL-6 in the poor prognosis group were higher than those in the good prognosis group at admission,and at 1 d,3 d and 7 d after admission(P<0.05,P<0.01).The levels of UAR,CURB-65 score,hs-CRP,PCT and IL-6 were firstly increased and then decreased at admission,and at 1 d,3 d and 7 d after admission in both groups.Pearson corre-lation analysis showed that UAR and CURB-65 scores were positively correlated with hs-CRP,PCT and IL-6 levels in patients with severe pneumonia at admission,and at 1 d,3 d and 7 d after admission(P<0.01).Before and after adjusting for other factors,UAR,CURB-65 score,hs-CRP,PCT and IL-6 were independently correlated with poor prognosis in patients with se-vere pneumonia at admission(P<0.01).Receiver operating characteristic(ROC)curve showed that the area under the ROC curve(AUC)of UAR,and CURB-65 score,combined with hs-CRP,PCT and IL-6,for predicting poor prognosis at admis-sion was 0.928,which was greater than that predicted by each indicator alone[0.748,0.712,0.772,0.767,and 0.746,respectively](P<0.05,P<0.01).Conclusion Combined detection of UAR,CURB-65 score,hs-CRP,PCT and IL-6 is of high value in predicting poor prognosis in patients with severe pneumonia.