Should we have any predictive marker for estimating the severity of community-acquired pneumonia at admission?

Abstract

Aim: Community-acquired pneumonia (CAP) is a disease that affects children. One hundred fifty-five million children under five years are diagnosed with pneumonia yearly, 20 million are hospitalized, and 2 million die. Early diagnosis and severity assessment reduce mortality and morbidity. This study aimed to determine the effect of basic hemogram parameters, neutrophil-lymphocyte ratio (NLR), immature (IG) granulocyte, immature granulocyte percentage (IG%), C-reactive protein (CRP), and oxygen saturation. Material and Method: This case-control study was conducted between November 2018 and May 2019 at Erciyes University School of Medicine in the Department of Paediatric Pulmonology. Sixty-nine patients diagnosed with CAP had enrolled in the study by clinical and radiological findings. The patients were classified into two subgroups: mild-to-moderate pneumonia and severe pneumonia. The CAP severity of the disease was determined using the criteria indicated for children by the British Thoracic Society. Univariate analysis was used to identify independent factors that affect the severity of pneumonia. Results: Pneumonia was mild-moderate in 46.3% (n=32/69) patients. Pneumonia was severe in 63% (n=37/69) of patients. Leukocytes, neutrophils, IGn, IG%, and saturations of these two groups were compared. There was a statistically significant difference between the two groups (p 0.05). However, there was no statistically significant difference in lymphocyte count, NLR, or CRP (p>0.05). Leukocytes, neutrophils, IGn, IG%, and saturation significantly predicted pneumonia severity (p<0.05). Conclusion: Our studies show that increased IGn, IG%, and decreased oxygen saturation are related to severe outcomes in children with pneumonia. They may be effective parameters in determining the severity of pneumonia.

Keywords

• Community-acquired pneumonia
• children
• immature granulocyte
• oxygen saturation
• disease severity

Başvuru sırasında toplum kökenli pnömoninin ciddiyetini tahmin etmek için herhangi bir prediktif belirtecimiz olmalı mı?

Abstract

Amaç: Toplum kökenli pnömoni (TKP), çocukları etkileyen önemli bir hastalıktır. Her yıl beş yaş altı yüz elli beş milyon çocuğa zatürre teşhisi konmakta, 20 milyonu hastaneye kaldırılmakta ve 2 milyonu ölmektedir. Erken tanı ve şiddet değerlendirmesi mortalite ve morbiditeyi azaltır. Bu çalışmada temel hemogram parametreleri, nötrofil-lenfosit oranı, immatür granülosit, immatür granülosit yüzdesi, CRP ve oksijen satürasyonunun hastalık şiddetine etkisinin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Bu vaka-kontrol çalışması, Kasım 2018-Mayıs 2019 tarihleri arasında Erciyes Üniversitesi Tıp Fakültesi Çocuk Göğüs Hastalıkları Anabilim Dalı’nda yürütülmüştür. Klinik ve radyolojik bulgulara göre TKP tanısı konan altmış dokuz hasta çalışmaya dahil edildi. Hastalar hafif-orta pnömoni ve şiddetli pnömoni olmak üzere iki alt gruba ayrıldı. Bulgular: Hafif-orta pnömonisi (%32/46,3) ve şiddetli pnömonisi (%37/53,6) olan hastaların lökosit, nötrofil, IGn, IG% ve satürasyonu karşılaştırıldı. İki grup arasında istatistiksel olarak anlamlı fark vardı (p 0,05). Ancak lenfosit sayısı, nötrofil lenfosit oranı (NLO) veya CRP’de istatistiksel olarak anlamlı bir fark yoktu (p>0,05). Pnömoninin şiddetini etkileyen bağımsız faktörleri belirlemek için tek değişkenli analiz kullanıldı. Lökositler, nötrofiller, immatür granülosit, immatür granülosit yüzdesi ve saturasyon, pnömoninin şiddetini öngörmede önemli bir etkiye sahipti (p<0,05). Sonuç: Çalışmamız, artan immatür granülosit, immatür granülosit yüzdesi % ve azalmış oksijen satürasyonunun pnömonili çocuklarda ciddi sonuçlarla ilişkili olduğunu göstermektedir. Pnömoninin şiddetini belirlemede hastaneye başvuruda bu parametreler etkili olabilirler.

Keywords

• Toplum kökenli pnömoni
• çocuklar
• immatür granülosit
• oksijen satürasyonu
• hastalık şiddeti

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