Clinical value of the combined CTI and CALLY index in assisting the diagnosis of heart failure in elderly patients with acute exacerbation of chronic obstructive pulmonary disease

doi:10.11958/20253236

Abstract

Abstract:

Objective To investigate the clinical value of C-reactive protein-triglyceride-glucose index (CTI) combined with the C-reactive protein-albumin-lymphocyte (CALLY) index in the auxiliary diagnosis of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with heart failure (HF) in elderly patients. Methods Clinical data of 260 elderly patients with AECOPD were retrospectively analyzed. The CTI and CALLY index were calculated. Patients were divided into the AECOPD+HF group (n=117) and the AECOPD without HF group (n=143) based on the presence or absence of HF. Multivariate Logistic regression analysis was used to identify factors influencing HF in elderly patients with AECOPD. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP), CTI and CALLY index for HF. Results Compared with the AECOPD without HF group, in the AECOPD with HF group, the age, the proportion of diabetes and hypertension increased, the course of COPD was prolonged, the CALLY index decreased, and the serum creatinine, NT-proBNP and CTI increased (P<0.05). Multivariate Logistic regression showed that elevated CTI was an independent risk factor for HF in elderly patients with AECOPD (OR = 1.253, 95%CI: 1.164-1.349, P<0.001), while the elevated CALLY index was an independent protective factor (OR = 0.786, 95%CI: 0.693-0.892, P<0.001). The area under the curve (AUC) for CTI alone, CALLY index alone and their combination in diagnosing HF in elderly patients with AECOPD was 0.791 (95%CI: 0.736-0.839), 0.781 (95%CI: 0.726-0.830) and 0.877 (95%CI: 0.830-0.914), respectively. The diagnostic value of the combined detection was superior to that of CTI or CALLY index alone (P<0.05). Conclusion The combination of CTI and CALLY index has high value in the auxiliary diagnosis of HF in elderly patients with AECOPD.

Key words: pulmonary disease, chronic obstructive, acute exacerbation, heart failure, aged, C-reactive protein-triglyceride-glucose index, CALLY index

CLC Number:

R563.9，R541.6

Figures/Tables 4

References 24

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组别		n	性别（男/女）		年龄/岁	COPD病程/年		吸烟史	饮酒史		基础疾病					Hb/（g/L）
组别		n	性别（男/女）		年龄/岁	COPD病程/年		吸烟史	饮酒史		糖尿病	高血压		血脂异常		Hb/（g/L）
未合并HF组		143	81/62		70.43±6.36	6（5，8）		93（65.0）	85（59.4）		28（19.6）	46（32.2）		33（23.1）		137.93±16.45
AECOPD＋HF组		117	78/39		73.33±7.43	7（6，9）		84（71.8）	78（66.7）		43（36.8）	64（54.7）		39（33.3）		134.53±19.89
χ²、t或Z			2.721		3.338^＊	2.337^＊		1.353	1.437		9.559^＊	13.386^＊＊		3.381		1.509
组别	NEU/（×10⁹/L）			Scr/（μmol/L）			UA/（μmol/L）			NT-proBNP/（ng/L）			CTI		CALLY指数
未合并HF组	4.28±1.16			79.04（63.90，90.70）			351.04（291.44，426.98）			160.30（114.99，266.17）			2.15（1.72，2.78）		1.30（1.02，1.51）
AECOPD＋HF组	4.50±1.20			84.66（74.16，99.69）			374.16（253.40，486.35）			396.00（194.03，810.61）			3.19（2.42，3.75）		0.83（0.58，1.15）
χ²、t或Z	1.530			2.426^＊			1.005			7.379^＊＊			8.067^＊＊		7.795^＊＊

组别		n	性别（男/女）		年龄/岁	COPD病程/年		吸烟史	饮酒史		基础疾病					Hb/（g/L）
组别		n	性别（男/女）		年龄/岁	COPD病程/年		吸烟史	饮酒史		糖尿病	高血压		血脂异常		Hb/（g/L）
未合并HF组		143	81/62		70.43±6.36	6（5，8）		93（65.0）	85（59.4）		28（19.6）	46（32.2）		33（23.1）		137.93±16.45
AECOPD＋HF组		117	78/39		73.33±7.43	7（6，9）		84（71.8）	78（66.7）		43（36.8）	64（54.7）		39（33.3）		134.53±19.89
χ²、t或Z			2.721		3.338^＊	2.337^＊		1.353	1.437		9.559^＊	13.386^＊＊		3.381		1.509
组别	NEU/（×10⁹/L）			Scr/（μmol/L）			UA/（μmol/L）			NT-proBNP/（ng/L）			CTI		CALLY指数
未合并HF组	4.28±1.16			79.04（63.90，90.70）			351.04（291.44，426.98）			160.30（114.99，266.17）			2.15（1.72，2.78）		1.30（1.02，1.51）
AECOPD＋HF组	4.50±1.20			84.66（74.16，99.69）			374.16（253.40，486.35）			396.00（194.03，810.61）			3.19（2.42，3.75）		0.83（0.58，1.15）
χ²、t或Z	1.530			2.426^＊			1.005			7.379^＊＊			8.067^＊＊		7.795^＊＊

变量	β	SE	Wald χ²	P	OR（95%CI）
年龄	0.076	0.039	3.878	0.049	1.079（1.000~1.164）
COPD病程	0.101	0.081	1.548	0.213	1.107（0.943~1.298）
糖尿病	0.862	0.375	5.282	0.022	2.368（1.135~4.939）
高血压	0.889	0.322	7.607	0.006	2.433（1.293~4.577）
Scr	0.061	0.037	2.721	0.099	1.063（0.989~1.144）
NT-proBNP	0.008	0.002	22.250	<0.001	1.008（1.005~1.011）
CTI	0.226	0.038	35.733	<0.001	1.253（1.164~1.349）
CALLY指数	-0.240	0.064	13.974	<0.001	0.786（0.693~0.892）
常数项	-11.794	3.887	9.205	0.002	0.000

变量	β	SE	Wald χ²	P	OR（95%CI）
年龄	0.076	0.039	3.878	0.049	1.079（1.000~1.164）
COPD病程	0.101	0.081	1.548	0.213	1.107（0.943~1.298）
糖尿病	0.862	0.375	5.282	0.022	2.368（1.135~4.939）
高血压	0.889	0.322	7.607	0.006	2.433（1.293~4.577）
Scr	0.061	0.037	2.721	0.099	1.063（0.989~1.144）
NT-proBNP	0.008	0.002	22.250	<0.001	1.008（1.005~1.011）
CTI	0.226	0.038	35.733	<0.001	1.253（1.164~1.349）
CALLY指数	-0.240	0.064	13.974	<0.001	0.786（0.693~0.892）
常数项	-11.794	3.887	9.205	0.002	0.000

变量		AUC（95%CI）		截断值		敏感度/%
NT-proBNP		0.766（0.710~0.816）		361.32 ng/L		73.50
CTI		0.791（0.736~0.839）		3.09		52.14
CALLY指数		0.781（0.726~0.830）		0.91		67.52
CTI＋CALLY指数		0.877（0.830~0.914）		0.43^＊		82.05
变量	特异度/%		阳性预测值/%		阴性预测值/%		约登指数
NT-proBNP	63.64		62.29		74.27		0.371
CTI	91.61		83.94		70.10		0.438
CALLY指数	76.92		71.13		74.27		0.444
CTI＋CALLY指数	81.12		77.97		84.62		0.632