Effectiveness of S100 calcium-binding protein A12 combined with modified early warning score in the clinical diagnosis of adult community-acquired pneumonia

Xiao-Lian Zhou; Lu-Ying Shu; Qiao Liu; Jian Deng; Dan Wang; Duo Li

doi:10.21037/jtd-23-1114

Effectiveness of S100 calcium-binding protein A12 combined with modified early warning score in the clinical diagnosis of adult community-acquired pneumonia

J Thorac Dis. 2024 Feb 29;16(2):839-846. doi: 10.21037/jtd-23-1114. Epub 2024 Feb 2.

Authors

Xiao-Lian Zhou¹, Lu-Ying Shu², Qiao Liu³, Jian Deng⁴, Dan Wang⁵, Duo Li^{5

6}

Affiliations

¹ Department of Pulmonary and Critical Care Medicine, Chengdu Second People's Hospital, Chengdu, China.
² Department of Pulmonary and Critical Care Medicine, Chongzhou People's Hospital, Chengdu, China.
³ Department of Pulmonary and Critical Care Medicine, Jiangjin Central Hospital of Chongqing, Chongqing, China.
⁴ Department of Medical Laboratory, the Affiliated Hospital of Southwest Medical University, Luzhou, China.
⁵ Department of Pulmonary and Critical Care Medicine, The Affiliated Hospital, Southwest Medical University, Luzhou, China.
⁶ Department of Hospital Infection Management, The Affiliated Hospital, Southwest Medical University, Luzhou, China.

Abstract

Background: Recent studies have found that S100 serum calcium-binding protein A12 (S100A12) has important significance in the expression of acute infectious diseases, and has high clinical application value in the differential diagnosis, prognosis and other aspects of acute infectious diseases. The accuracy of modified early warning score (MEWS) in evaluating the disease risk level of critically ill patients is comparable to Acute Physiology and Chronic Health Evaluation (APACHE II).

Methods: Based on MEWS, 108 adult community-acquired pneumonia (CAP) patients were divided into the low-risk, intermediate-risk, and high-risk groups. The differences in invasive mechanical ventilation rate and mortality rate among each group were compared, and the differences of S100A12 in different levels of MEWS scores were compared through one-way analysis of variance. According to the prognosis after 30 days, the patients were divided into the death group and the survival group. Univariate and multivariate logistic regression analyses were used to study the influencing and independent factors of 30-day death in CAP patients. The sensitivity and specificity of S100A12, procalcitonin (PCT), and MEWS scores in predicting the 30-day death in CAP patients were evaluated using the receiver operating characteristic (ROC) curve, as well as the area under each indicator curve.

Results: The serum S100A12 concentration increased with the increase in the MEWS stratification, and the mechanical ventilation and mortality rates also increased significantly. Univariate and multivariate analyses were used to explore the factors influencing mortality in adult CAP patients after 30 days. The receiver-operating characteristics curve was used to analyze the sensitivity, specificity, and area under the curves of serum S100A12, PCT, and MEWS in predicting mortality in CAP patients after 30 days.

Conclusions: The serum S100A12, PCT, and MEWS can effectively predict the mortality risk in adult CAP patients after 30 days. Serum S100A12 combined with MEWS has a high clinical application value in evaluating the severity and prognosis of adult CAP.

Keywords: S100A12; clinical application value; community-acquired pneumonia (CAP); modified early warning score (MEWS); procalcitonin (PCT).