Geriatrik Pnömoni Ciddiyeti ve Mortalite Sonuçlarında İmmatür Granülositler ve Çekirdekli Eritrositlerin Prognostik Önemi

Abstract

Amaç: Yaşlı nüfusta pnömoninin seyri katastrofik olabilir. Pnömoninin ciddiyetini değerlendirebilen biyobelirteçler, prognozda önemli rol oynamaktadırlar. Bu çalışmada, geriatrik pnömoninin ciddiyetinin potansiyel göstergeleri olarak, immatür granülositlerin (İG) ve çekirdekli eritrositlerin (ÇE) kinetikleri değerlendirilmiştir. Gereç ve yöntem: Bu retrospektif ve kesitsel çalışmada, pnömoni tanısı konan hastalar, CURB-65 (Konfüzyon, Üre, Solunum sayısı, Kan basıncı, yaş >65) ve PSI (Pnömoni ciddiyet endeksi) olmak üzere iki önde gelen ciddiyet skorlama sistemine göre kategorize edilmiştir. Ayrıca, hastaların taburculuk durumu ve enfeksiyon süreci belirteçleri kaydedilmiştir. Bulgular: Toplamda 80 hasta değerlendirmeye dahil edilmiştir ve yaş ortalamaları 72.23 ± 7.26'dır. Onkoloji hastaları dahil edildiğinde %49 olan mortalite oranı, hariç tutulduklarında %26 idi. Ölen hastaların hastanede yatış süreleri daha uzundu, CURB-65 ve PSI kategori dereceleri daha yüksek sınıftaydı ve NRBC seviyeleri yükselmişti. CURB-65 tabanlı kategorizasyonda, hastalık şiddeti ile sadece NRBC düzeyinde artış gözlenirken, PSI tabanlı kategorizasyonda hem NRBC hem de IG düzeylerinde artış mevcuttu. Onkoloji hastaları analizden çıkarıldığında NRBC ve IG düzeylerinde istatistiksel fark gözlenmedi. Sonuç: Geriatrik pnömoni vakalarında, NRBC'nin dinamiklerinin, IG'ye kıyasla hastalık şiddetini belirtmede daha hayati olduğu görünmektedir. Ancak, onkolojik komorbiditesi olan hastalarda bu fırsatın zayıfladığı ya da kaybolduğu görülmektedir.

Keywords

• CURB-65
• Çekirdekli eritrosit
• İmmatür granülosit
• Pnömoni ciddiyet endeksi

Unveiling the Prognostic Significance of Immature Granulocytes and Nucleated Red Blood Cells in Geriatric Pneumonia Severity and Mortality Outcomes

Abstract

Aim: The progression of pneumonia in the senior-age population can be catastrophic. Biomarkers capable of assessing the severity of pneumonia play a pivotal role in prognosis. We conducted an evaluation of the kinetics of immature granulocytes (IG) and nucleated red blood cells (NRBC) as potential indicators of the severity of geriatric pneumonia. Materials & Methods: In this retrospective cross-sectional study, patients diagnosed with pneumonia were categorized using two prominent severity scoring systems, CURB-65 (Confusion, Urea, Respiratory rate, Blood pressure, age >65) and PSI (Pneumonia severity index). Additionally, the patients' discharge status and infection process markers were noted. Results: A total of 80 patients were included in the evaluation, with a mean age of 72.23 ± 7.26. Excluding the mortality rate of 49% when including oncology patients, the overall mortality rate was 26%. The deceased patients had longer hospitalization durations, higher CURB-65 and PSI category classifications, and elevated NRBC results. In CURB-65-based categorization, there was an increase only in NRBC levels associated with disease severity, whereas, in PSI-based categorization, there was an increase in both NRBC and IG levels. No statistical difference was observed in NRBC and IG levels when excluding oncology patients from the analysis. Conclusion: In geriatric pneumonia cases, the dynamics of NRBC appear to be more crucial in indicating disease severity compared to IG. However, this opportunity seems to be missed or compromised in patients with oncological comorbidities.

Keywords

• CURB-65
• Immature granulocyte
• Nucleated red blood cell
• Pneumonia severity index.

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