Comparison of CRP, procalcitonin, neutrophil counts,
sTREM-1,opn,clinical status and short-term outcomes between pneumonic
and non-pneumonic exacerbations in COPD patients
Abstract
introduction:The patients with Community-Acquired Pneumonia(CAP) could
have a higher risk of acute and severe respiratory illness than those
without CAP in acute exacerbations of COPD(AECOPD).consequently,early
identification of pneumonia in AECOPD is quite important. metholds:62
subjects with AECOPD+CAP and 107 subjects with AECOPD were enrolled from
two clinical centers. Clinical parameters and the values of osteopontin
(OPN),soluble triggering receptor expressed on myeloid cells-1
(sTrem-1), C-reactive protein (CRP),procalcitonin (PCT),and neutrophil
counts (NEU) were measured and compared in AECOPD and AECOPD+CAP on the
first day of admission. results:patients with AECOPD+CAP has increased
presence of fever, sputum volume,sputum purulence,diabetes
mellitus,lower blood pressure, and higher carbon dioxide partial
pressure than AECOPD patients(p<0.05).At day1,AECOPD+CAP
patients had higher values of NEU,CRP,PCT and OPN,while serum sTREM-1
levels were similar in the two groups. CRP fares best at predicting
acute exacerbation of COPD with pneumonia with an area under the curve
(AUC) of 0.78, while OPN had similar accuracy with Neu and PCT.the AUC
value of OPN,Neu and PCT was 0.61(95% CI 0.53-0.68) , 0.63(95% CI
0.55-0.70) and 0.68(95% CI 0.60-0.75) respectively(p<0.05 for
the test of difference). In multivariate analysis, plasma levels of
CRP≥15.8 mg/dL at day 1 and sputum purulence were promising predictors
of pneumonia in AECOPD. Conclusions:Patients with CAP in AECOPD patients
present more clinical parameters and increased biomarker levels but
similar short-term outcomes. Combined with plasma CRP level and the
clinical characteristic of purulent sputum can be used to predict COPD
complicated with pneumonia.