Background: The aim is to investigate the predictive values of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), procalcitonin (PCT) and C-reactive protein (CRP) for multiple trauma-induced acute respiratory distress syndrome (ARDS) complicated with pulmonary infection.
Methods: One hundred and twelve patients with multiple trauma-induced ARDS admitted from April 2019 to April 2021 were selected and divided into infection group (n = 49) and non-infection group (n = 63). Their general data and laboratory test indicators were compared. Multivariate logistic regression analysis was utilized to identify the influencing factors for concurrent pulmonary infection. Pearson’s analysis was employed to analyze the correlations of sTREM-1, PCT, and CRP with other influencing factors. The predictive values of sTREM-1, PCT, and CRP for pulmonary infection in ARDS patients were evaluated using receiver operating characteristic (ROC) curves. Based on the cutoff values, the patients were assigned to low-, medium-, and high-risk groups. Survival curves were plotted by Kaplan-Meier method to compare the 28-day survival.
Results: The infection group had significantly higher injury severity score (ISS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, sTREM-1, PCT, CRP, and macrophage inflammatory protein (MIP)-1α, longer tracheal intubation time and intensive care unit (ICU) stay time, and lower oxygenation index than those of the non-infection group (p < 0.05). Multivariate logistic regression analysis revealed that increased ISS, APACHE II score, as well as elevated blood concentrations of sTREM-1, PCT, CRP and MIP-1α were risk factors for concurrent pulmonary infection (p < 0.05). sTREM-1, PCT, and CRP were positively correlated with ISS, APACHE II score, and MIP-1α (p < 0.05). The areas under ROC curves of sTREM-1, PCT, CRP, and their combination were 0.795, 0.784, 0.756, and 0.860, respectively (p < 0.001), indicating high predictive values. The survival rate of the high-risk group (46.43%) was significantly lower than those of the low-risk group (89.58%) and medium-risk group (75.00%) (p < 0.05).
Conclusions: sTREM-1, PCT, and CRP are highly expressed in serum of patients with multiple trauma-induced ARDS complicated with pulmonary infection. The combined detection of three markers is of high predictive value.