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Publications

Journal Article Epublish

PubMed: 38528884 DOI: 10.2147/CIA.S454239

Predictive Value of Lysophosphatidylcholine for Determining the Disease Severity and Prognosis of Elderly Patients with Community-Acquired Pneumonia.

Clin Interv Aging 19:517-527

Authors: Minghao Gu, SenSen Lv, Yihui Song, Hong Wang, Xingyu Zhang, Jing Liu, Deshun Liu, Xiudi Han, Xuedong Liu

Affiliations

  • Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao, 266011, People's Republic of China.
  • School of Medicine, Qingdao University, Qingdao, 266071, People's Republic of China.
  • Department of Neurology, Weihai Municipal Hospital, Weihai, 264200, People's Republic of China.
  • Hospital-Acquired Infection Control Department, Qingdao Municipal Hospital, Qingdao, 266011, People's Republic of China.
  • Human Resources Department, Qingdao Municipal Hospital, Qingdao, 266011, People's Republic of China.

Abstract

Purpose

To investigate the clinical value of serum lysophosphatidylcholine (LPC) as a predictive biomarker for determining disease severity and mortality risk in hospitalized elderly patients with community-acquired pneumonia (CAP).

Methods

This prospective, single-center study enrolled 208 elderly patients, including 67 patients with severe CAP (SCAP) and 141 with non-SCAP between November 1st, 2020, and November 30th, 2021 at the Qingdao Municipal Hospital, Shandong Province, China. The demographic and clinical parameters were recorded for all the included patients. Serum LPC levels were measured on day 1 and 6 after admission using ELISA. Propensity score matching (PSM) was used to balance the baseline variables between SCAP and non-SCAP patient groups. Receiver operative characteristic (ROC) curve analysis was used to compare the predictive performances of LPC and other clinical parameters in discriminating between SCAP and non-SCAP patients and determining the 30-day mortality risk of the hospitalized CAP patients. Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors associated with SCAP. Cox proportional hazard regression analysis was used to determine if serum LPC was an independent risk factor for the 30-day mortality of CAP patients.

Results

The serum LPC levels at admission were significantly higher in the non-SCAP patients than in the SCAP patients (P = 0.011). Serum LPC level <24.36 ng/mL, and PSI score were independent risk factors for the 30-day mortality in the elderly patients with CAP. The risk of 30-day mortality in the elderly CAP patients with low serum LPC levels (< 24.36ng/mL) was >5-fold higher than in the patients with high serum LPC levels (≥ 24.36ng/mL).

Conclusion

Low serum LPC levels were associated with significantly higher disease severity and 30-day mortality in the elderly patients with CAP. Therefore, serum LPC is a promising predictive biomarker for the early identification of elderly CAP patients with poor prognosis.

MeSH

Lysophosphatidylcholines, Regression Analysis, Mortality, Serum, Predictive Value Of Tests, Biomarkers, Aged, Pneumonia, Risk Factors, Health Services For The Aged, Prognosis, Community-Acquired Pneumonia