Division of Anesthesiology, Department of Acute Medicine, Geneva University Hospital, Geneva, Switzerland.
Department of Internal Medicine Specialties, Medical Faculty, Geneva University Hospitals, Geneva, Switzerland.
BMC Geriatr. 2024 Aug 24;24(1):709. doi: 10.1186/s12877-024-05270-0.
Elderly patients with suspected pneumonia represent a significant proportion of hospital admissions, which is a prognostic challenge for physicians. Our research aimed to assess the prognosis of patients with pneumonia using soluble urokinase plasminogen activator receptor (suPAR) combined with clinical data.
In a prospective observational study including 164 patients > 65 years (mean age 84.2 (+/-7.64) years) who were hospitalized for a suspicion of pneumonia, suPAR was assessed for each patient, as was the prognosis score (PSI, CURB65) and inflammatory biomarkers (C-reactive protein, procalcitonin, white blood cells). The prognostic value of the suPAR for 30-day mortality was assessed using receiver operating characteristic (ROC) curve analyses. Optimal cut-offs with corresponding sensitivity (SE) and specificity (SP) were determined using the Youden index.
A suPAR > 5.1 ng/mL was predictive of 30-day mortality with a sensitivity of 100% and a specificity of 40.4%. A combination of the following parameters exhibited an SE of 100% (95% CI, 100-100) for an SP value of 64.9% (95% CI, 57.6-72.2) when at least two of them were above or below the following cut-off threshold values: suPAR > 9.8 ng/mL, BMI < 29.3 kg/m2 and PSI > 106.5.
The suPAR seems to be a promising biomarker that can be combined with the PSI and BMI to improve the prognosis of pneumonia among elderly patients. Prospective studies with larger populations are needed to confirm whether this new approach can improve patient outcomes.
ClinicalTrials.gov (NCT02467192), 27th may 2015.
疑似肺炎的老年患者在住院患者中占很大比例，这对医生的预后评估构成了挑战。我们的研究旨在评估使用可溶性尿激酶型纤溶酶原激活物受体（suPAR）结合临床数据对肺炎患者的预后。
在一项包括 164 名年龄>65 岁（平均年龄 84.2（+/-7.64）岁）因疑似肺炎住院的患者的前瞻性观察研究中，评估了每位患者的 suPAR，以及预后评分（PSI、CURB65）和炎症生物标志物（C 反应蛋白、降钙素原、白细胞）。使用受试者工作特征（ROC）曲线分析评估 suPAR 对 30 天死亡率的预后价值。使用约登指数确定最佳截断值及其相应的敏感性（SE）和特异性（SP）。
suPAR>5.1 ng/mL 可预测 30 天死亡率，敏感性为 100%，特异性为 40.4%。当至少两个参数超过或低于以下截断值时，以下参数的组合具有 100%的 SE（95%CI，100-100）和 64.9%（95%CI，57.6-72.2）的 SP 值：suPAR>9.8 ng/mL、BMI<29.3 kg/m2 和 PSI>106.5。
suPAR 似乎是一种很有前途的生物标志物，可与 PSI 和 BMI 结合使用，以改善老年肺炎患者的预后。需要更大人群的前瞻性研究来证实这种新方法是否可以改善患者的预后。
ClinicalTrials.gov（NCT02467192），2015 年 5 月 27 日。
