Open AccessPredictive value of α‐amylase in tracheal aspirates for ventilator‐associated pneumonia in elderly patients
Author(s) -
Qu GePing,
Fang XiangQun,
Xu YaPing,
Shi Min,
Wang Yang,
Gong MeiLiang,
Fang HaoMing
Publication year - 2018
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12729
Subject(s) - medicine , tracheal intubation , intubation , ventilator associated pneumonia , receiver operating characteristic , mechanical ventilation , pneumonia , amylase , incidence (geometry) , aspiration pneumonia , area under the curve , surgery , biochemistry , chemistry , physics , optics , enzyme
Objective This study aims to investigate the correlation between α‐amylase in tracheal aspirates and risk factors of aspiration, as well as ventilator‐associated pneumonia (VAP), in elderly patients undergoing mechanical ventilation and explore the clinical value of α‐amylase for predicting VAP. Methods Tracheal aspirates were collected from elderly patients within 2 weeks after tracheal intubation in mechanical ventilation, and α‐amylase was detected. Patients were grouped according to the presence of VAP. The correlation between α‐amylase and risk factors of aspiration before intubation, as well as VAP, were analyzed. Results The sample of this study comprised 147 patients. The average age of these patients was 86.9 years. The incidence of VAP was 21% during the study period. Tracheal aspirate α‐amylase level increased with the increase in the number of risk factors for aspiration before intubation, α‐amylase level was significantly higher in the VAP group than in the non‐VAP group, the area under the receiver operating characteristic curve (ROC) of the diagnostic value of α‐amylase for VAP was 0.813 (95% CI: 0.721‐0.896), threshold value was 4,681.5 U/L, sensitivity was 0.801 and specificity was 0.793. Logistic multivariate analysis revealed the following risk factors for VAP: a number of risk factors before intubation of ≥3, a Glasgow score of <8 points, the absence of continuous aspiration of subglottic secretion and a tracheal aspirate α‐amylase level of >4681.5 U/L. Conclusion Tracheal aspirate α‐amylase can serve as a biomarker for predicting VAP in elderly patients undergoing mechanical ventilation.