Prognostic value of circFLNA, extravascular lung water index and pulmonary ultrasound score in acute lung injury patients

Abstract Objectives Inflammatory responses are pivotal in the progression of acute lung injury (ALI), with circular RNA FLNA (circFLNA) emerging as a key suppressor in sepsis-induced ARDS models. This study investigates how circFLNA, in conjunction with extravascular lung water index (EVLWI) and lung ultrasound score (LUS), predicts outcomes in ALI patients. Methods CircFLNA expression was quantified via qRT-PCR, and its prognostic significance, alongside EVLWI and LUS, was evaluated using Logistic regression analysis and receiver operating characteristic (ROC) curve. Results Serum circFLNA levels were markedly higher in ALI patients compared to controls (p<0.001). Logistic regression analysis indicated that EVLWI (OR=1.565, 95 % CI=1.266–1.935, p<0.001), LUS (OR=1.543, 95 % CI=1.214–1.962, p<0.001), and circFLNA (OR=6.209, 95 % CI=1.880–20.515, p=0.003) were distinctly related to death of ALI patients. The area under the curve (AUC) of circFLNA for the death of ALI patients was 0.717 (95 % CI=0.625–0.810) with a sensitivity of 0.722 and a specificity of 0.676. ROC demonstrated that a combination of circFLNA, EVLWI, and LUS had high prognostic value for 28-day death of ALI patients (AUC=0.909, 95 % CI=0.863–0.955, sensitivity=0.944, specificity=0.748, p=0.001). Conclusions CircFLNA was upregulated in ALI patients and was positively correlated with a high risk of death in ALI patients. Combination of EVLWI, LUS, and circFLNA had a high predictive value for death in ALI patients.