Toplum kökenli pnömönide serum albümin ve CRP/albümin oranının hastalık seyrine etkisi

Year 2022, , 111 - 116, 28.06.2022

Derya Hoşgün , Esen Sayın Gülensoy , Evrim Akpınar , Nalan Ogan , Can Ateş , Semih Aydemir

https://doi.org/10.47582/jompac.1128249

Cited By: 2

Abstract

Amaç:Toplum kökenli pnömöni (TKP) solunum yolu enfeksiyonları içinde yüksek mortalite ve morbiditeye sahiptir.Tanı, tedavi, prognoz takibinde çeşitli biokimyasal markerlar kullanılmaktadır.CRP, albümin rutin uygulamada sıklıkla kullanılan biokimyasal markerlardır.İnflamasyon temellli CRP/albümin oranı çeşitli hastalıklarda prognoz tahmininde kullanılmaktadır.Postoperatif yoğun bakıma kabul edilen hastalarda yapılan çalışmalarda 30 günlük ve 1 yıllık mortalite tahmininde bağımsız risk faktörü olarak bulunmuştur.Çeşitli klinik durumlarda CRP/albümin oranı tek başına albümin ve CRP’den daha iyi inflamatuvar durumu yansıttığı düşünülmektedir.Bu çalışmanın amacı TKP nedeniyle hastaneye yatırılan CRP/albümin oranının 30 günlük mortalite tahminindeki rolünü belirlemekti.Çalışmanın ikincil sonlanım noktası ise yoğun bakım ihtiyacı idi.
Gereç Ve Yöntem:Göğüs hastalıkları ve yoğun bakım servisine yatırılan TKP’li hastalar çalışmaya dahil edildi. Retrospektif olarak hasta dosyaları, radyolojik incelemeleri ve laboratuvar bulguları tarandı.
Bulgular:Yüz(%55.9)’ü göğüs hastalıkları servisinde 79’u yoğun bakımda yatmakta olan 179 TKP’li hasta çalışmaya dahil edildi. Hastaların yaş ortalaması 72.027±12.88 yıldı, %61.5’i erkek, %38.5’i kadındı.CRP değeri ve CRP/albümin oranı 30 günlük mortalite ve yoğun bakım ihtiyacını tahmin etmede anlamlı bulunmazken (sırasıyla p:0.728, p:0.232, p:0.110), düşük albümin değerlerinin mortalite ve yoğun bakım ihtiyacı riskini anlamlı derecede artırdığı bulundu(p<0.001, p<0.001).CURB-65, PSI ve albümin 30 günlük mortalite ve yoğun bakım ihtiyacını tespit etmede anlamlı bulunan değişkenlerdir.
Sonuç:
Albumin değerinin yüksek olması TKP’de 30 günlük mortalite ve yoğun bakım ihtiyacı riskini azaltmaktadır. CRP , CRP/albümin oranının TKP’de kısa dönem mortalite ve morbiditeyi tahmin edememektedir. TKP’li hastalarda serum albümin, CRP düzeyleri ve CRP/albümin oranının uzun dönem prognozu tahmin gücünü ortaya koymak için geniş kohortlarda, çok merkezli çalışmalara ihtiyaç vardır.

Keywords

Toplum kökenli pnömöni, biyomarkerlar, mortalite, prognoz

Supporting Institution

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Project Number

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Serum albumin and C-reactive protein/albumin ratio in community-acquired pneumonia

Abstract

Introduction: Community-acquired pneumonia (CAP) is a common type of respiratory tract infections with high morbidity and mortality. Prognostic role of CRP/Albumin ratio in CAP patients still is unknown. The aim of this study was to investigate the role the CRP/albumin ratio in predicting 30-day mortality and ICU requirement in hospitalized patients with CAP.
Material and Method: The study included patients with CAP.Clinical records and plain radiographic images of the patients were retrieved from hospital database and were reviewed for each patient.
Results: The 179 CAP patients who were hospitalized were included. CRP level and the CRP/albumin ratio were found to have no significant effect on mortality and ICU requirement (p=0.728, p=0.232, and p=0.110, respectively), whereas low albumin level was associated with high mortality and ICU requirement (p<0.001 for both).
Conclusion: Increased albumin concentration was associated with a lower risk of 30-day mortality. The CRP/albumin ratio was found to have no significant role in predicting short-term mortality and morbidity in CAP patients. Further large-scale, multicenter studies are needed to investigate the prognostic value of the CRP/albumin ratio in predicting long-term prognosis in CAP patients

Keywords

Community-acquired pneumonia, biomarkers, mortality, prognosis

Project Number

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