Correlation of Serum Clara Cell Secretory Protein 16, Plasma Fibrinogen and Serum Amyloid A with the Severity of Acute Exacerbated COPD and Their Combination in Prognosis Assessment

Figures & data

Table 1 Analysis of Prognostic Factors in Patients with Acute Exacerbated Chronic Obstructive Pulmonary Disease (AECOPD)

Factors	Good (n=151)	Poor (n=69)	p value
Age (years)	59.05 ± 10.62	64.39 ± 12.58	0.003
COPD course (years)	10.77 ± 4.09	11.61 ± 3.97	0.065
Body mass index (kg/m^2)	24.10 ±4.32	25.07 ±4.39	0.129
Gender
Male	83 (54.9%)	43 (62.3%)	0.378
Female	68 (45.1%)	26 (37.7%)
GOLD
I–II	87 (57.6%)	22 (31.9%)	< 0.001
III–IV	64 (42.4%)	47 (68.1%)
Complicated diabetes mellitus
Yes	21 (13.9%)	20 (29.0%)	0.014
No	130 (86.1%)	49 (71.0%)
Complicated hypertension
Yes	25 (16.6%)	16 (23.2%)	0.265
No	126 (83.4%)	53 (76.8%)
Complicated hyperlipidemia
Yes	38 (25.2%)	21 (30.4%)	0.417
No	113 (74.8%)	48 (69.6%)
Complicated coronary heart disease
Yes	42 (27.8%)	35 (50.7%)	0.001
No	109 (72.2%)	34 (49.3%)
Smoke
Yes	88 (58.3%)	44 (63.8%)	0.462
No	63 (41.7%)	25 (36.2%)
PaCO2 (mmHg)	47.42 ± 5.97	52.47 ± 8.54	< 0.001
Serum CC16 (ng/mL)	18.45 ± 7.34	25.98 ± 9.13	< 0.001
Plasma FIB (g/L)	3.54 ± 0.91	4.39 ± 1.18	< 0.001
SAA (mg/L)	8.27 ± 4.02	14.74 ± 6.23	< 0.001

Notes: The data are presented with mean ± SD or n (percentage). The p values were calculated by Mann–Whitney test, Unpaired t test with Welch’s correction or Fisher’s exact test.

Abbreviations: GOLD, global initiative for chronic obstructive lung disease; CC16, Clara cell secretory protein⁃16; FIB, fibrinogen; SAA, serum amyloid A.

Table 2 Multivariate Logistic Analysis for Poor Prognosis in Patients with Acute Exacerbated Chronic Obstructive Pulmonary Disease (AECOPD)

	OR	95% CI	p value
Age more than 65 years old	1.174	1.032 to 1.313	0.014
GOLD (III–IV)	2.371	1.795 to 2.952	0.002
Complicated diabetes mellitus	1.085	1.023 to 1.149	0.026
Complicated coronary heart disease	1.693	1.248 to 2.139	0.003
PaCO2 more than 50 mmHg	1.336	1.225 to 1.446	0.008
Serum CC16 more than 20 ng/mL	1.219	1.102 to 1.335	0.011
Plasma FIB more than 4 g/L	1.196	1.075 to 1.317	0.018
SAA more than 10 mg/L	1.287	1.095 to 1.479	0.009

Abbreviations: OR, Odds Ratio; CI, confidence interval; GOLD, global initiative for chronic obstructive lung disease; CC16, Clara cell secretory protein⁃16; FIB, fibrinogen; SAA, serum amyloid A.

Table 3 Predictive Values in ROC Analysis

	AUC	95% CI	p	Sensitivity (%)	Specificity (%)	Youden Index	Cut off
Serum CC16	0.75	0.67 to 0.82	<0.001	72.46	69.54	0.42	20.44 ng/mL
Plasma FIB	0.71	0.64 to 0.79	<0.001	60.87	72.85	0.34	4.07 g/L
SAA	0.81	0.75 to 0.88	<0.001	81.16	72.19	0.53	9.98 mg/L
Combination	0.89	0.84 to 0.94	<0.001	76.81	88.74	0.66	7.05

Notes: ^&Logit (Combination) = 0.095 *CC16 + 0.495 *FIB + 0.245 *SAA.

Abbreviations: CI, confidence interval; CC16, Clara cell secretory protein⁃16; FIB, fibrinogen; SAA, serum amyloid A.

Figure 1 Comparisons of serum CC16 (A), plasma FIB (B) and SAA (C) at admission between AECOPD patients with good prognosis (n = 151) and poor prognosis (n = 69) in one year follow-up. P values were calculated from Mann–Whitney test. Spearman correlation analysis of serum CC16 with plasma FIB (D), serum CC16 with SAA (E), plasma FIB with SAA (F) in all the AECOPD patients (n = 220), p < 0.001 in three analyses.

Figure 2 Correlation of serum CC16, plasma FIB and SAA with the severity of AECOPD. Comparisons of serum CC16 (A), plasma FIB (B) and SAA (C) at admission between AECOPD patients with GOLD class of I–II (n = 109) and III–IV (n = 111). P values were calculated from Mann–Whitney test. Spearman correlation analysis of PaCO₂ with serum CC16 (D), plasma FIB (E) and SAA (F) in all the AECOPD patients (n = 220), p < 0.001 in three analyses.

Figure 3 ROC analysis of predictive values of serum CC16, plasma FIB, SAA at admission and their combination test for the prognosis assessment of AECOPD in one year follow-up.