Prognostic value of serum copeptin, MMP-9 and MEWS scores in patients with severe pneumonia

Chen Liang; Zhuo Yue; Zeng Zong-ding; Zhang Lu-lu; Xing Chong-hao

doi:10.3969/j.issn.1002-1949.2018.05.004

Abstract：Objective To investigate the value of serum copeptin,matrix metalloproteinase-9 (MMP-9) and modified early warning score (MEWS) in the assessment and the prognosis in elderly patients with severe pneumonia (SP).Methods Three hundred and eight cases of elderly SP patients in our ICU were prospectively studied.The changes of serum copeptin and MMP-9 levels were recorded,and the MEWS score and the prognosis of patients were recorded.The value of serum copeptin,MMP-9 and MEWS scores on the prognosis of elderly patients with SP were analyzed by using the ROC curve.Results The MEWS score (7.22 ± 2.78 vs.2.60 ± 1.65) in the death group was significantly higher than that in the survival group (t =8.602,P ＜ 0.05),and the fatality rate increasedwith the increase of the MEWS score.On the first,third and fifth day of the death group,the serum copeptin and MMP-9 levels were significantly higher than those of the survival group [copeptin (pmol/L):67.48-± 13.60 vs.38.70 ± 10.45,82.92 ± 18.37 vs.34.61 ± 11.50,74.60 ± 15.36 vs.27.18±8.30,MMP-9 (ng/mL):236.26 ±43.37 vs.182.74 ±38.58,311.28 ±51.42 vs.170.48 ± 35.16,284.20 ± 48.36 vs.147.16 ± 32.05,all P ＜ 0.05].The ROC curve showed that the prediction of copeptin third day,MMP-9 third day and MEWS score of death in patients with SP,the optimal cut-off values were 58.42 pmol/L,243.38 ng/mL and 5.30 points,its sensitivity and specificity were 80.2％ and 87.8％,72.6％ and 80.5％,71.0％ and 84.8％,respectively.Conclusion Serum copeptin,MMP-9 and MEWS scores are correlated with the severity and prognosis of elderly SP patients,and the serum copeptin level on the third day can accurately predict the 28-day mortality of patients.