Abstract
Background Severe pneumonia (SP) has been widely accepted as a major cause for acute respiratory distress syndrome (ARDS), and the development of ARDS is significantly associated with increased mortality. This study aimed to identify potential predictors for ARDS development in patients with SP. Methods Eligible SP patients at admission from January 2013 to June 2017 were prospectively enrolled, and ARDS development within hospital stay was identified. Risk factors for ARDS development in SP patients were analyzed by univariate and multivariate logistic regression analysis. The receiver operating characteristic (ROC) curve analysis with the area under the curve (AUC) was performed for the predictive value of endocan for ARDS development. Results A total of 145 SP patients were eventually enrolled into the final analysis, of which 37 developed ARDS during the hospital stay. Our final multivariate logistic regression analysis suggested plasma endocan expression as the only independent risk factor for ARDS development in SP patients (OR: 1.57, 95% CI: 1.14–2.25, P=0.021). ROC curve analysis of plasma endocan resulted in an AUC of 0.754, 95% CI of 0.642–0.866, a cutoff value of 11.6 ng/mL, a sensitivity of 78.7%, and a specificity of 70.3%, respectively (P < 0.01). Conclusions Endocan expression at ICU admission is a reliable predictive factor in predicting ARDS in patients with SP.
Highlights
Acute respiratory distress syndrome (ARDS), a common devastating problem encountered in critically ill patients, is closely associated with acute respiratory failure, limited life quality, and high mortality [1, 2]
Severe pneumonia (SP) has been widely accepted as a major cause for acute respiratory distress syndrome (ARDS), and the development of ARDS is significantly associated with increased mortality [4]. e overlap of clinical symptoms in SP and ARDS results in the difficulty of identification of ARDS from SP [5]. erefore, the early predication and risk stratification of ARDS in patients with SP is of great importance to improve the prognosis
A total of 145 SP patients were eventually enrolled into the final analysis, of which 37 developed ARDS during the hospital stay with the average time of 7.1 days. e percentage of SP patients who developed ARDS was 25.5% in this present study, which was quite in accordance with other results [15]. e demographic and clinical characteristics are summarized in Table 1. e sequential organ failure assessment (SOFA) score was calculated to be lower, while the lung injury score (LIS) was higher in those SP patients who developed ARDS
Summary
Acute respiratory distress syndrome (ARDS), a common devastating problem encountered in critically ill patients, is closely associated with acute respiratory failure, limited life quality, and high mortality [1, 2]. Severe pneumonia (SP) has been widely accepted as a major cause for ARDS, and the development of ARDS is significantly associated with increased mortality [4]. Severe pneumonia (SP) has been widely accepted as a major cause for acute respiratory distress syndrome (ARDS), and the development of ARDS is significantly associated with increased mortality. Risk factors for ARDS development in SP patients were analyzed by univariate and multivariate logistic regression analysis. E receiver operating characteristic (ROC) curve analysis with the area under the curve (AUC) was performed for the predictive value of endocan for ARDS development. Our final multivariate logistic regression analysis suggested plasma endocan expression as the only independent risk factor for ARDS development in SP patients (OR: 1.57, 95% CI: 1.14–2.25, P 0.021).
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