Prognostic value of multivariate logistic regression analysis and amyloid A lactate monitoring in patients with severe pneumonia-associated sepsis.

Abstract

Background: Patients with severe pneumonia-associated sepsis often face high mortality rates, highlighting the need for simple and effective prognostic biomarkers. This study aimed to investigate the prognostic significance of serum amyloid A (SAA) and blood lactate (Lac) levels using multivariate logistic regression.

Method: This was a retrospective study conducted from January 2021 to December 2023, which included 156 patients diagnosed with severe pneumonia. Of these, 54 developed sepsis (septic group) while 102 did not (non-septic group). Clinical data, SAA, and Lac levels were compared between the groups. Multivariate logistic regression was employed to identify factors influencing the onset of severe pneumonia-associated sepsis and to assess the prognostic significance of SAA and Lac.

Result: Significant differences were found in APACHE II score, SOFA score, age, mechanical ventilation, SAA, and Lac levels between the septic and non-septic groups (P < 0.05). Logistic regression analysis identified age, SOFA score, APACHE II score, mechanical ventilation, SAA, and Lac as influencing factors for severe pneumonia-associated sepsis (P < 0.05). Patients with poor prognosis (PP) had significantly elevated SAA and Lac levels compared to those with good prognosis (GP) (P < 0.05). Among septic patients, those with PP had significantly higher SAA and Lac levels compared to those with GP (P < 0.05). Multivariate logistic regression revealed that advanced age, septic shock, elevated SAA levels, and increased Lac levels were predictors of PP (P < 0.05). The prognostic value of SAA and Lac was demonstrated by AUCs of 0.764 and 0.771, respectively. When combined, the AUC increased to 0.903 with a specificity of 95.00% and sensitivity of 80.25%.

Conclusion: Severe pneumonia-associated sepsis is influenced by age, SOFA score, APACHE II score, mechanical ventilation, SAA, and Lac levels. Elevated SAA and Lac levels are associated with PP and can provide prognostic information for adverse outcomes. While SAA and Lac show potential as biomarkers for predicting the prognosis of severe pneumonia-associated sepsis, their clinical utility should be considered in conjunction with other diagnostic and clinical factors for effective patient management and risk stratification.