Authors

Yiyu Hong*, Yaqin Li**, Zhaozhong Xu*, #

Departments

*Department of Emergency, Zhujiang Hospital of Southern Medical University, Guangzhou, PR China - **Southern Medical University, Guangzhou, PR China

Abstract

Objective: To analyse the predictive value of the glycaemic lability index (GLI), C-reactive protein (CRP) levels, albumin levels, and the CRP/albumin ratio in the risk of death in patients with critical pneumonia. 

Methods: A total of 126 patients admitted to the respiratory medicine department of our hospital between January 2017 and November 2018 with critical pneumonia were enrolled. We divided the patients into a survival group of 88 patients and a death group of 38 patients according to the mortality within 28 days. Data were used to compare the changes in the blood-glucose-related index, CRP levels, albumin levels, and the CRP/albumin ratio. Logistic regression analysis was used to analyse the independent risk factors of prognosis in patients with critical pneumonia. The value of the GLI and the CRP/albumin ratio in predicting the risk of death in patients with critical pneumonia was analysed by receiver operating characteristic (ROC) curve. 

Results: The mean and standard deviation of blood glucose levels and the GLI in the death group were significantly higher than those of the survival group (P<0.05). The CRP levels and CRP/albumin ratios in the death group were significantly higher than those of the survival group, and albumin levels were significantly lower in the death group than in the survival group; these differences were statistically significant (P<0.05). Logistic regression analysis revealed that GLI, CRP/albumin ratio, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and CURB-65 score were independent factors influencing the deaths of patients (P<0.05). The results of ROC curve analysis indicated that the sensitivity of the GLI and CRP/albumin ratios in patients with critical pneumonia was 85.3% and 91.6%, respectively; the specificity was 73.1% and 48.7%, respectively, and the area under the curve was 0.801 and 0.809, respectively. The GLI and CRP/albumin ratio can therefore be used as specific indicators for predicting the risk of death in patients with critical pneumonia. 

Conclusion: The blood glucose fluctuation in patients with critical pneumonia is closely related to the mortality rate. The GLI and CRP/albumin ratio can be used as independent risk factors for death in critical pneumonia patients and have a certain predictive value for the risk of death in patients with severe pneumonia, providing some guidance for clinical treatment.

Keywords

Blood glucose instability index, CRP/albumin ratio, critical pneumonia, risk of death, clinical value.

DOI:

10.19193/0393-6384_2020_3_306