Association of acute phase reactants with prognostic scores in community acquired pneumonia

2020 ◽  
pp. 1-14
Author(s):  
Sefer Ozkaya ◽  
Serhad Omercikoglu ◽  
Erhan Altunbas ◽  
Haldun Akoglu ◽  
Arzu Denizbasi ◽  
...  
Keyword(s):  
Pneumonia Severity Index ◽  
Scoring Systems ◽  
Community Acquired Pneumonia ◽  
Prognostic Scores ◽  
Risk Scores ◽  
British Thoracic Society ◽  
C Reactive Protein ◽  
Acute Phase Reactants ◽  
Key Words Pneumonia ◽  
Reactive Protein

Abstract Objective: To investigate the association of C-reactive protein and procalcitonin with commonly used prognostic scoring systems, hospitalisation and mortality in cases of community-acquired pneumonia. Methods: The prospective study was conducted from April 2014 to April 2015 at the emergency department of Marmara University Pendik Research and Training Hospital,Turkey, and comprised community-acquired pneumonia patients diagnosed according to the British Thoracic Society criteria. Prognosis was estimated using confusion, urea, respiratory rate, blood pressure and age ?65, Pneumonia Severity Index-Pneumonia Patient Outcome Research Team score, and severe community-acquired pneumonia scores. Data was analysed using MedCalc 15.8. Results: Of the 203 patients assessed, community-acquired pneumonia was confirmed in 152(74.8%). Procalcitonin had moderate correlation with the three scales used (p<0.001), while C-reactive protein had weak correlation with them (p<0.004). Conclusion: Both procalcitonin and C-reactive protein levels were found to be correlated with prognostic risk scores. Key Words: Pneumonia, C reactive protein, procalcitonin, Continuous...

scholarly journals The prognostic and risk-stratified value of neutrophil–lymphocyte count ratio in Chinese patients with community-acquired pneumonia

2017 ◽  
Vol 15 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Ting Yang ◽  
Chun Wan ◽  
Hao Wang ◽  
Jiangyue Qin ◽  
Lei Chen ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Lymphocyte Count ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Serum Levels ◽  
Community Acquired Pneumonia ◽  
C Reactive Protein ◽  
Pneumonia Severity ◽  
Reactive Protein ◽  
Count Ratio

Community-acquired pneumonia is a common disease associated with high mortality. This retrospective study examined whether the neutrophil–lymphocyte count ratio (NLR), already widely used as an index of inflammation, can be used to predict in-hospital mortality of adults with community-acquired pneumonia. Clinical characteristics, CURB-65 and pneumonia severity index score of pneumonia severity, NLR, serum levels of C-reactive protein and procalcitonin, and in-hospital mortality were analyzed for 318 consecutive adults with community-acquired pneumonia admitted to West China Hospital between July 2012 and December 2013. The ability of NLR and other parameters to predict in-hospital mortality was assessed using receiver operating characteristic (ROC) curves. Results showed that NLR increased with increasing CURB-65 ( P < 0.05) and pneumonia severity index ( P < 0.05), and NLR correlated positively with serum levels of C-reactive protein (r = 0.239, P < 0.05) and procalcitonin (r = 0.211, P < 0.05). The median value of NLR was significantly higher among patients who died in hospital (11.96) than among those who were alive at the end of hospitalization (4.19, P < 0.05). Based on a cut-off NLR of 7.12, this index predicted in-hospital mortality with a sensitivity of 82.61% and specificity of 72.20% (area under ROC curve, 0.799). Predictive power was greater for the combination of NLR and serum levels of C-reactive protein and procalcitonin. These results suggest that NLR may be useful for predicting prognosis in Chinese adults with community-acquired pneumonia, and it may work better in combination with traditional markers.

scholarly journals EXPRESS: Serum biomarkers for prediction of mortality in patients with COVID-19

2021 ◽  
pp. 000456322110142
Author(s):  
Rohit S Loomba ◽  
Enrique G Villarreal ◽  
Juan S Farias ◽  
Gaurav Aggarwal ◽  
Saurabh Aggarwal ◽  
...  
Keyword(s):  
High Sensitivity ◽  
Hepatic Function ◽  
Pooled Analysis ◽  
Cardiac Biomarkers ◽  
Limited Information ◽  
C Reactive Protein ◽  
Acute Phase Reactants ◽  
Reactive Protein ◽  
Prediction Of Mortality ◽  
Novel Coronavirus

Background There is limited information regarding the role of biomarker levels at predicting mortality in patients with the novel coronavirus pandemic (Covid-19). The purpose of this study is to determine the differences in serum biomarker levels in adults with Covid-19 who survived hospitalization from those who did not. Methods A comprehensive search was completed on PubMed, EMBASE, and Cochrane libraries to identify studies of interest. Endpoints of interest were blood counts, hepatic function test, acute phase reactants, cytokines and cardiac biomarkers. Results A total of 10 studies with 1,584 patients were included in the pooled analyses. Biomarkers that were noted to be significantly higher in those who died from Covid-19 (coronavirus disease 2019) included: white blood cell count, neutrophil count, C-reactive protein, high sensitivity C-reactive protein, procalcitonin, ferritin, D-dimer, interleukins 6, lactate dehydrogenase, creatine kinase, prothrombin time, aspartate aminotransferase, alanine aminotransferase, total bilirubin, and creatinine. Lymphocyte count, platelet count, and albumin were significantly lower in patients who died. Conclusion This pooled analysis of 10 studies including 1,584 patients identified significant differences in biomarkers on admission in patients who survived from those who did not. Further research is needed to develop risk stratification models to help with judicious use of limited healthcare resources.

scholarly journals Utility of procalcitonin, C-reactive protein and white blood cells alone and in combination for the prediction of clinical outcomes in community-acquired pneumonia

2015 ◽  
Vol 53 (4) ◽  
Author(s):  
Andriy Zhydkov ◽  
Mirjam Christ-Crain ◽  
Robert Thomann ◽  
Claus Hoess ◽  
Christoph Henzen ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Blood Cells ◽  
White Blood Cells ◽  
Community Acquired Pneumonia ◽  
Adverse Clinical Outcome ◽  
C Reactive Protein ◽  
Prognostic Information ◽  
Reactive Protein

AbstractThe added value of biomarkers, such as procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBC), as adjuncts to clinical risk scores for predicting the outcome of patients with community-acquired pneumonia (CAP) is in question. We investigated the prognostic accuracy of initial and follow-up levels of inflammatory biomarkers in predicting death and adverse clinical outcomes in a large and well-defined cohort of CAP patients.We measured PCT, CRP and WBC on days 1, 3, 5, and 7 and followed the patients over 30 days. We applied multivariate regression models and area under the curve (AUC) to investigate associations between these biomarkers, the clinical risk score CURB-65, and clinical outcomes [i.e., death and intensive care unit (ICU) admission].Of 925 patients with CAP, 50 patients died and 118 patients had an adverse clinical outcome. None of the initial biomarker levels significantly improved the CURB-65 score for mortality prediction. Follow-up biomarker levels showed significant independent association with mortality at days 3, 5, and 7 and with improvements in AUC. Initial PCT and CRP levels were independent prognostic predictors of adverse clinical outcome, and levels of all biomarkers during the course of disease provided additional prognostic information.This study provides robust insights into the added prognostic value of inflammatory markers in CAP. Procalcitonin, CRP, and to a lesser degree WBC provided some prognostic information on CAP outcomes, particularly when considering their kinetics at days 5 and 7 and when looking at adverse clinical outcomes instead of mortality alone.

scholarly journals Effects of statins on clinical outcomes in hospitalized patients with community-acquired pneumonia

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052093858
Author(s):  
Rony M. Zeenny ◽  
Hanine Mansour ◽  
Wissam K Kabbara ◽  
Nibal Chamoun ◽  
Myriam Audi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Length Of Stay ◽  
Hospital Length ◽  
Community Acquired Pneumonia ◽  
Hospital Length Of Stay ◽  
Comorbid Conditions ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Significant Difference ◽  
Chronic Use

Objective We evaluated the effect of chronic use of statins based on C-reactive protein (CRP) levels and hospital length of stay (LOS) in patients admitted with community-acquired pneumonia (CAP). Methods We conducted a retrospective study over 12 months at a teaching hospital in Lebanon comparing patients with CAP taking chronic statins with patients not taking statins. Included patients with CAP were older than age 18 years and had two CRP level measures during hospitalization. CURB-65 criteria were used to assess the severity of pneumonia. A decrease in CRP levels on days 1 and 3, LOS, and normalization of fever were used to assess the response to antibiotics. Results Sixty-one patients were taking statins and 90 patients were not taking statins. Patients on statins had significantly more comorbid conditions; both groups had comparable CURB-65 scores. In both groups, no statistically significant difference was seen for the decrease in CRP level on days 1 and 3 and LOS. No difference in days to normalization of fever was detected in either group. Conclusion No association was found between the chronic use of statins and CRP levels, LOS, or days to fever normalization in patients with CAP.

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