Procalcitonin/Albumin Ratio: Could it be a Novel Marker Indicating Severity of Inflammation in Pneumonia? A Retrospective Study in Elderly Patients with Community-acquired Pneumonia

Yıl 2020, Cilt: 3 Sayı: 1, 11 - 17, 30.04.2020

Recep Alanlı , Murat Bülent Küçükay , Serkan Yalçın

Öz

Aim: Community-acquired pneumonia (CAP) in elderly patients is a major health problem causing morbidity and mortality. Markers for determining the severity of disease are still insufficient. With this study conducted on geriatric age group patients treated in intensive care unit (ICU) with CAP; it was aimed to evaluate the importance and usability of procalcitonin/albumin ratio for predicting progression of disease or mortality.

Material and Methods: This retrospective study was conducted in a tertiary hospital, on geriatric age group patients who were hospitalized in ICU with diagnosis of community-acquired pneumonia, between January 1, 2016 and December 31, 2018. Total 490 patients were followed-up and 350 who met inclusion criteria were enrolled in the study. One hundred and sixty two patient (46%) were female and 188 (54%) were male, mean age was 73.5±10.9. On admission to ICU, blood tests, blood and sputum cultures has been obtained from all patients. Accompanying diseases, age, gender data has been recorded, complete blood count (leukocyte, platelet count, MPV), CRP, uric acid, procalcitonin and albumin has been studied.

Results: Age (p=0.005), procalcitonin (p=0.001), MPV (p=0.001), CRP (p=0.002) and procalcitonin/albumin ratio (p=0.001) were found to be significant between groups in survivors and fatalities. In 30-day follow up period, 166 patients survived, while 188 patients died. Area under curve (AUC) value for procalcitonin/albumin ratio was significant when compared to other parameters (p=0.001).

Conclusion: The relationship between thirty-day mortality in ICU and age, procalcitonin/albumin ratio, procalcitonin, CRP and MPV values were significant. 

Anahtar Kelimeler

Intensive care unit, mortality, pneumonia, procalcitonin

Prokalsitonin/Albumin Oranı: Pnömoni Şiddetini Gösteren Yeni Bir Belirteç Olabilir mi? Toplum Kaynaklı Pnömonisi olan Hastalarda Yapılmış Retrospektif Bir Çalışma

Öz

Amaç: Bu çalışmada; yoğun bakıma toplum kaynaklı pnömoni (TKP) nedeniyle yatırılan geriatrik yaş grubundaki hastalarda, prokalsitonin/albümin oranının pnömoni seyrini ve mortaliteyi göstermekteki etkinliği değerlendirilmiştir.

Gereç ve Yöntemler: Bu çalışma, geriatrik yaş grubundaki hastalarda, 1 Ocak 2016 - 31 Aralık 2018 tarihleri arasında TKP tanısı konularak, hastane yoğun bakım ünitesinde yatırılmış 490 hastadan çalışmaya dahil edilme kriterleri uyan 350'si ile tek merkezli ve retrospektif olarak yapılmıştır. Hastaların 162 (%46)'si kadın, 188 (%54)'i ise erkek idi. Hastaların yaş ortalaması 73,50±10,9 yıldı. Hastaların 30 günlük mortalite oranıyla; eşlik eden hastalıkları, yaş, cinsiyet, lenfosit, nötrofil ve trombosit sayısı, ortalama trombosit hacmi (MPV), C-reaktif protein (CRP), ürik asit, prokalsitonin ve albumin değerleri arasındaki ilişki değerlendirilmiştir. Hastaların biyokimya testleri, kan ve balgam kültürleri; yoğun bakıma yatırıldığı anda alınmıştır.

Bulgular: Yaşayan ve ölen hasta grupları arasında; yaş (p=0,005), prokalsitonin (p=0,001), MPV (p=0,001), CRP (p=0,002) ve prokalsitonin/albumin oranı (p=0,001) değerleri arasından anlamlı fark saptanmıştır. Otuz günlük takip sırasında; hastaların 166 tanesi yaşamını sürdürürken, 184 hasta yaşamını yitirmiştir. Prokalsitonin/albumin oranının eğri altında kalan alan (AUC) değeri, diğer parametrelerden anlamlı olarak fazla bulunmuştur (p=0,001).

Sonuç: Yoğun bakımda toplum kökenli pnömoni nedeniyle yatırılan hastalarda 30 günlük mortalite oranı ile yaş, CRP, MPV, prokalsitonin değerleri ve prokalsitonin/albumin oranının anlamlı olarak ilişkili olduğu saptanmıştır.

Anahtar Kelimeler

Mortalite, pnömoni, prokalsitonin, prokalsitonin/albumin oranı, yoğun bakım

Kaynakça

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