Document Type : Original Article

Authors

1 Department of Respiratory and Critical Care Medicine, Suzhou High-tech Zone People's Hospital, Suzhou 215123, Jiangsu Province, China.

2 Department of Emergency Medicine, The Fourth Affiliated Hospital of Soochow University (Suzhou Dushu Lake Hospital), Suzhou, China.

3 Department of Emergency Medicine, Suzhou High-tech Zone People's Hospital, Suzhou 215123, Jiangsu Province, China.

Abstract

Background: Severe chronic obstructive pulmonary disease (COPD) patients with pulmonary infections face higher morbidity and mortality.
Objective: To investigate mononuclear cell membrane CD14 as a prognostic marker for their outcome.
Methods: A total of 311 participants were included: 122 in the coinfection group, 127 in the severe COPD group, and 62 in the control group. The patients in the coinfection group were categorized into survival (n=106) and death (n=16) groups based on hospitalization prognosis. The CD14%, CD14MFI, and CD14IND values were compared between the groups. Death risk factors were assessed by COPD grading, FEV1% pred, FEV1/FVC, CD14%, CD14MFI, and CD14IND. Correlations between CD14 parameters and mortality, COPD grade, FEV1%pred, and FEV1/FVC were analyzed. The critical value for CD14IND to predict patient death was determined and survival rates were compared between the high and the low-risk groups.
Results: CD14% values were significantly lower in the COPD and co-infection groups than in the control groups (p<0.05). The survival group showed a steady increase in mCD14 expression, while the death group showed fluctuating low levels. Low value of CD14% was identified as a risk factor for death and correlated with mortality and COPD severity (p<0.001). CD14IND≤74.36 predicted death with 91.22% sensitivity and 95.51% specificity. The high-risk group had a significantly lower 30-day survival rate (68.42%) compared with the low-risk group (95.24%) (log-rank χ2=10.067, p=0.002).
Conclusion: The CD14 parameters of mononuclear cell membranes prove to be promising markers for predicting prognosis and death in severe COPD patients with lung infection.

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