Etiological Distribution And Risk Factors Of Patients With Cardiac Insufficiency Complicated With Pulmonary Infection

Objective: To explore the etiological distribution and influencing factors of patients with cardiac insufficiency complicated with pulmonary infection, and to analyze the diagnostic efficacy of procalcitonin (PCT), C-reactive protein (CRP), brain natriuretic peptide (BNP) and norepinephrine (NE) in the diagnosis of this disease. Methods: This study was a prospective study in which 164 patients with cardiac insufficiency were enrolled and divided into the infection group (43 patients) and the non-infected group (121 patients) according to whether they were complicated with pulmonary infection. Pathogen analysis and drug susceptibility test were performed on patients in the infected group. Serum PCT, CRP, BNP and NE levels were measured in the two groups, and the general data of the two groups were collected and compared. Multivariate Logistic regression analysis was further carried out for the indicators with statistical differences in univariate analysis, and ROC curve was employed to analyze the diagnostic efficacy of PCT, CRP, BNP and NE in diagnosing cardiac insufficiency complicated with pulmonary infection. Results: A total of 63 pathogenic bacteria were isolated from 43 patients, among which 43 were Gram-negative bacteria (68.25%), 18 were Gram-positive bacteria (28.57%), and 2 were fungi (3.17%). Among the Gram-negative bacteria, Pseudomonas aeruginosa and Klebsiella pneumoniae were highly resistant to cefuroxime, ampicillin and levofloxacin, while Staphylococcus aureus and Staphylococcus haemolyticus of Gram-positive bacteria were highly resistant to penicillin, erythromycin and gentamicin. Univariate analysis showed that there were significant differences between the two groups in age, length of hospital stay, cardiac function grading, smoking history, diabetes mellitus, invasive procedures, serum PCT, CRP, BNP and NE levels (P<0.05). Multivariate regression logistic regression analysis further demonstrated that; age >60 years old, long hospital stay, diabetes mellitus, invasive procedures and high levels of serum PCT, CRP, BNP and NE were independent risk factors for pulmonary infection in patients with cardiac insufficiency (P<0.05). ROC curve exhibited that PCT, CRP, BNP and NE had high clinical value in the diagnosis of cardiac insufficiency complicated with pulmonary infection (AUC>0.7, P<0.001). Conclusion: Gram-negative bacteria are the main cause of cardiac insufficiency complicated with pulmonary infection, and that drugs should be rationally used according to drug sensitivity results. Age 60 years, long hospital stay, diabetes, invasive procedures and high serum PCT, CRP, BNP and NE can increase the risk of infection in patients with cardiac insufficiency. Serum PCT, CRP, BNP and NE have high clinical value in the diagnosis of cardiac insufficiency complicated with pulmonary infection.