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Comparison of the Effectiveness of LAR and CURB-65 Scores in Determining Hospitalization Decisions in Acute Pneumonia Patients

Year 2024, Volume: 3 Issue: 3, 97 - 102, 28.12.2024
https://doi.org/10.61745/jsmsau.1578115

Abstract

Objective: This study aims to assess the efficiency of the Lactate/Albumin Ratio (LAR) and CURB-65 scoring in determining the need for hospitalization in acute pneumonia patients in the emergency department.
Methods: Our study was conducted retrospectively in the emergency department of a tertiary hospital from 1 February, 2024, to 1 August, 2024. Patients who presented with lower respiratory tract infections and were diagnosed with acute pneumonia between 01.02.2024 and 01.08.2024 were included in our study. All patient information was collected from electronic medical records.
Results: A total of 77 patients were included in the study, of which 30 were hospitalized. The mean age of the patients was 68.8 ± 12.2 years, and 46.8% (n=36) were male. When comparing patients discharged from the emergency department with those admitted to the hospital, the discharged group had lower respiratory rate, BUN, lactate, CURB-65, and LAR values, which were statistically significant (P<.05). LAR was negatively correlated and statistically significant with SBP, DBP and pH (P<.05). It was positively correlated and statistically significant with lactate and CURB-65 (P <.001).
Conclusion: Our study found that the LAR may be indicative of the need for hospitalization in acute pneumonia patients. However, the CURB-65 scoring system was more successful than LAR in predicting hospitalization.

References

  • Ehsanpoor B, Vahidi E, Seyedhosseini J, Jahanshir A. Validity of SMART-COP score in prognosis and severity of community acquired pneumonia in the emergency department. Am J Emerg Med. 2018;37(8):1450-1454. doi:10.1016/j.ajem.2018.10.044
  • Hespanhol V, Bárbara C. Pneumonia mortality, comorbidities matter? Pulmonology. 2019;26(3):123-129. doi:10.1016/j.pulmoe.2019.10.003
  • Ramirez JA, File TM. How to assess survival prognosis in patients hospitalized for community-acquired pneumonia in 2024? Curr Opin Crit Care. 2024;30(5):399-405. doi:10.1097/mcc.0000000000001189
  • Shirata M, Ito I, Ishida T, et al. Development and validation of a new scoring system for prognostic prediction of community-acquired pneumonia in older adults. Sci Rep. 2021;11(1). doi:10.1038/s41598-021-03440-3
  • Certo M, Llibre A, Lee W, Mauro C. Understanding lactate sensing and signalling. Trends Endocrinol Metab. 2022;33(10):722-735. doi:10.1016/j.tem.2022.07.004
  • Wardi G, Brice J, Correia M, Liu D, Self M, Tainter C. Demystifying Lactate in the Emergency Department. Ann Emerg Med. 2019;75(2):287-298. doi:10.1016/j.annemergmed.2019.06.027
  • Manolis AA, Manolis TA, Melita H, Mikhailidis DP, Manolis AS. Low serum albumin: A neglected predictor in patients with cardiovascular disease. Eur J Intern Med. 2022;102:24-39. doi:10.1016/j.ejim.2022.05.004.
  • Eckart A, Struja T, Kutz A, et al. Relationship of Nutritional Status, Inflammation, and Serum Albumin Levels During Acute Illness: A Prospective Study. Am J Med. 2019;133(6):713-722.e7. doi:10.1016/j.amjmed.2019.10.031
  • Lau KK, Hsiao CT, Fann WC, Chang CP. Utility of the Lactate/Albumin Ratio as a Predictor for Mortality in Necrotizing Fasciitis Patients. Emerg Med Int. 2021;2021:1-5. doi:10.1155/2021/3530298
  • Chebl RB, Geha M, Assaf M, et al. The prognostic value of the lactate/albumin ratio for predicting mortality in septic patients presenting to the emergency department: a prospective study. Ann Med. 2021;53(1):2268-2277. doi:10.1080/07853890.2021.2009125
  • Patel S. Calculated decisions: CURB-65 score for pneumonia severity. Emerg Med Pract. 2021;23(Suppl 2):CD1-CD2. Published 2021 Feb 1.
  • Zhang L, Li Y, Lv C, et al. Predictive value of arterial blood lactate/serum albumin ratio for myocardial injury in elderly patients with severe community-acquired pneumonia. Medicine (Baltimore) 2022;101(4):e28739. doi:10.1097/md.0000000000028739
  • Xu C, Liu H, Zhang H, et al. Predictive value of arterial blood lactate to serum albumin ratio for in-hospital mortality of patients with community-acquired pneumonia admitted to the Intensive Care Unit. Postgrad Med. 2022;135(3):273-282. doi:10.1080/00325481.2022.2110769
  • Baek MS, Park S, Choi JH, Kim CH, Hyun IG. Mortality and Prognostic Prediction in Very Elderly Patients With Severe Pneumonia. J Intensive Care Med. 2019;35(12):1405-1410. doi:10.1177/0885066619826045
  • Terlecki M, Kocowska-Trytko M, Dadański E, et al. Prognostic accuracy of mean arterial pressure and serum lactate level among patients with acute myocardial infarction. Kardiol Pol. 2024;82(5):527-533. doi:10.33963/v.phj.100271
  • Beske RP, Søndergaard FT, Møller JE, et al. Treatment effects of blood pressure targets and hemodynamics according to initial blood lactate levels in comatose out-of-hospital cardiac arrest patients – A sub study of the BOX trial. Resuscitation. 2023;194:110007. doi:10.1016/j.resuscitation.2023.110007
  • Janotka M, Ostadal P. Biochemical markers for clinical monitoring of tissue perfusion. Mol Cell Biochem. 2021;476(3):1313-1326. doi:10.1007/s11010-020-04019-8
  • Qi J, Bao L, Yang P, Chen D. Comparison of base excess, lactate and pH predicting 72-h mortality of multiple trauma. BMC Emerg Med. 2021;21(1). doi:10.1186/s12873-021-00465-

Akut Pnömoni Hastalarında LAR ve CURB-65 Skorlarının Hastaneye Yatış Kararındaki Etkinliğinin Karşılaştırılması

Year 2024, Volume: 3 Issue: 3, 97 - 102, 28.12.2024
https://doi.org/10.61745/jsmsau.1578115

Abstract

maç: Bu çalışmanın amacı, akut pnömoni hastalarında hastaneye yatış gereksinimini belirlemede Laktat/Albümin Oranı (LAR) ve CURB-65 skorlama sisteminin etkinliğini değerlendirmektir.
Yöntemler: Çalışmamız, 1 Şubat 2024 ile 1 Ağustos 2024 tarihleri arasında bir üçüncül hastanenin acil servisinde retrospektif olarak gerçekleştirilmiştir. Akut pnömoni tanısı konan alt solunum yolu enfeksiyonu ile başvuran hastalar çalışmaya dahil edilmiştir. Tüm hasta bilgileri elektronik tıbbi kayıtlar üzerinden toplanmıştır.
Bulgular: Toplamda 77 hasta çalışmaya dahil edilmiştir; bunlardan 30'u hastaneye yatırılmıştır. Hastaların ortalama yaşı 68,8 ± 12,2 yıl olup, %46,8'i (n=36) erkektir. Acil servisten taburcu edilen, hastalar ile hastaneye yatışı yapılan hastalar karşılaştırıldığında, taburcu edilen grubun solunum hızı, BUN, laktat, CURB-65 ve LAR değerlerinin istatistiksel olarak anlamlı bir şekilde daha düşük olduğu görülmüştür (P<.05). LAR'ın sistolik kan basıncı (SKB), diastolik kan basıncı (DKB) ve pH ile negatif yönde ve istatistiksel olarak anlamlı bir korelasyonu olduğu bulunmuştur (P<.05). LAR, laktat ve CURB-65 ile pozitif yönde ve istatistiksel olarak anlamlı bir korelasyona sahipti (P<.001).
Sonuç: Çalışmamız, LAR'ın akut pnömoni hastalarında hastaneye yatış gereksinimini gösteren bir belirteç olabileceğini bulmuştur. Ancak, CURB-65 skorlama sisteminin hastaneye yatışı tahmin etmede LAR'dan daha başarılı olduğu görülmüştür.

References

  • Ehsanpoor B, Vahidi E, Seyedhosseini J, Jahanshir A. Validity of SMART-COP score in prognosis and severity of community acquired pneumonia in the emergency department. Am J Emerg Med. 2018;37(8):1450-1454. doi:10.1016/j.ajem.2018.10.044
  • Hespanhol V, Bárbara C. Pneumonia mortality, comorbidities matter? Pulmonology. 2019;26(3):123-129. doi:10.1016/j.pulmoe.2019.10.003
  • Ramirez JA, File TM. How to assess survival prognosis in patients hospitalized for community-acquired pneumonia in 2024? Curr Opin Crit Care. 2024;30(5):399-405. doi:10.1097/mcc.0000000000001189
  • Shirata M, Ito I, Ishida T, et al. Development and validation of a new scoring system for prognostic prediction of community-acquired pneumonia in older adults. Sci Rep. 2021;11(1). doi:10.1038/s41598-021-03440-3
  • Certo M, Llibre A, Lee W, Mauro C. Understanding lactate sensing and signalling. Trends Endocrinol Metab. 2022;33(10):722-735. doi:10.1016/j.tem.2022.07.004
  • Wardi G, Brice J, Correia M, Liu D, Self M, Tainter C. Demystifying Lactate in the Emergency Department. Ann Emerg Med. 2019;75(2):287-298. doi:10.1016/j.annemergmed.2019.06.027
  • Manolis AA, Manolis TA, Melita H, Mikhailidis DP, Manolis AS. Low serum albumin: A neglected predictor in patients with cardiovascular disease. Eur J Intern Med. 2022;102:24-39. doi:10.1016/j.ejim.2022.05.004.
  • Eckart A, Struja T, Kutz A, et al. Relationship of Nutritional Status, Inflammation, and Serum Albumin Levels During Acute Illness: A Prospective Study. Am J Med. 2019;133(6):713-722.e7. doi:10.1016/j.amjmed.2019.10.031
  • Lau KK, Hsiao CT, Fann WC, Chang CP. Utility of the Lactate/Albumin Ratio as a Predictor for Mortality in Necrotizing Fasciitis Patients. Emerg Med Int. 2021;2021:1-5. doi:10.1155/2021/3530298
  • Chebl RB, Geha M, Assaf M, et al. The prognostic value of the lactate/albumin ratio for predicting mortality in septic patients presenting to the emergency department: a prospective study. Ann Med. 2021;53(1):2268-2277. doi:10.1080/07853890.2021.2009125
  • Patel S. Calculated decisions: CURB-65 score for pneumonia severity. Emerg Med Pract. 2021;23(Suppl 2):CD1-CD2. Published 2021 Feb 1.
  • Zhang L, Li Y, Lv C, et al. Predictive value of arterial blood lactate/serum albumin ratio for myocardial injury in elderly patients with severe community-acquired pneumonia. Medicine (Baltimore) 2022;101(4):e28739. doi:10.1097/md.0000000000028739
  • Xu C, Liu H, Zhang H, et al. Predictive value of arterial blood lactate to serum albumin ratio for in-hospital mortality of patients with community-acquired pneumonia admitted to the Intensive Care Unit. Postgrad Med. 2022;135(3):273-282. doi:10.1080/00325481.2022.2110769
  • Baek MS, Park S, Choi JH, Kim CH, Hyun IG. Mortality and Prognostic Prediction in Very Elderly Patients With Severe Pneumonia. J Intensive Care Med. 2019;35(12):1405-1410. doi:10.1177/0885066619826045
  • Terlecki M, Kocowska-Trytko M, Dadański E, et al. Prognostic accuracy of mean arterial pressure and serum lactate level among patients with acute myocardial infarction. Kardiol Pol. 2024;82(5):527-533. doi:10.33963/v.phj.100271
  • Beske RP, Søndergaard FT, Møller JE, et al. Treatment effects of blood pressure targets and hemodynamics according to initial blood lactate levels in comatose out-of-hospital cardiac arrest patients – A sub study of the BOX trial. Resuscitation. 2023;194:110007. doi:10.1016/j.resuscitation.2023.110007
  • Janotka M, Ostadal P. Biochemical markers for clinical monitoring of tissue perfusion. Mol Cell Biochem. 2021;476(3):1313-1326. doi:10.1007/s11010-020-04019-8
  • Qi J, Bao L, Yang P, Chen D. Comparison of base excess, lactate and pH predicting 72-h mortality of multiple trauma. BMC Emerg Med. 2021;21(1). doi:10.1186/s12873-021-00465-
There are 18 citations in total.

Details

Primary Language English
Subjects Clinical Sciences (Other)
Journal Section Research Articles
Authors

Fatma Tortum 0000-0002-1876-5998

Publication Date December 28, 2024
Submission Date November 2, 2024
Acceptance Date December 6, 2024
Published in Issue Year 2024 Volume: 3 Issue: 3

Cite

AMA Tortum F. Comparison of the Effectiveness of LAR and CURB-65 Scores in Determining Hospitalization Decisions in Acute Pneumonia Patients. Atatürk Univ Fac Med J Surg Med Sci. December 2024;3(3):97-102. doi:10.61745/jsmsau.1578115

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