Association of Troponin, C-Reactive protein, Albumin and C-Reactive protein/Albumin Ratios with Mortality in Intensive Care Unit Patients with Community-acquired Pneumonia

Yıl 2024, Cilt: 8 Sayı: 3, 189 - 195, 30.12.2024

Nazım Onur Can , Şenol Arslan , Furkan Akpınar , Halil İbrahim Doru

https://doi.org/10.30565/medalanya.1525345

Öz

Aim: Parameters used to determine prognosis in community-acquired pneumonia (CAP) patients often have limited clinical value. This study aims to examine the efficacy of CRP, albumin, CRP/albumin ratio and troponin elevation in predicting 30-day mortality in patients hospitalized in the intensive care unit with CAP.

Material and Methods: In this study, 200 patients (85 females and 115 males) older than 18 years of age with a diagnosis of CAP who were followed up in the intensive care unit after emergency department admission between January 1, 2023 and January 1, 2024 were included. Patients who underwent chest radiography and biochemical analyses, including complete blood count, CRP and albumin, within the first 24 hours, were divided into two groups: those who died and those who survived. Troponin, CRP, albumin, and CRP/albumin ratios were compared between the groups about mortality.

Results: The findings obtained in our study were as follows: Troponin, CRP, albumin and CRP/albumin ratio values differed significantly in patients with mortality. When ROC analysis was performed to determine the power of troponin, CRP, albumin and CRP/albumin ratio to predict mortality in the emergency department, it was found that troponin value was the strongest marker in terms of sensitivity with 82.25%. In terms of specificity, low albumin was the most specific parameter, with 82.50% and CRP/albumin ratio followed albumin with 72.50%.

Conclusion: We believe that CRP, albumin, CRP/albumin and troponin are significant predictors of 30 day mortality in patients with CAP hospitalized in the intensive care unit.

Anahtar Kelimeler

Albumin, C-reactive protein, CRP/albumin, Pneumonia, Troponin

Toplum Kökenli Pnömonisi olan Yoğun Bakım Hastalarında Troponin, C-Reaktif protein, Albumin ve C-Reaktif protein/Albümin Oranlarının Mortalite ile İlişkisi

Öz

Amaç: Toplum kökenli pnömoni (TKP) hastalarında prognozu belirlemek için kullanılan parametreler sıklıkla sınırlı klinik değere sahiptir. Bu çalışmanın amacı TKP tanısıyla yoğun bakıma yatırılan hastalarda 30 günlük mortaliteyi öngörmede CRP, albümin, CRP/albümin oranı ve troponin yüksekliğinin etkinliğini incelemektir.

Gereç ve Yöntemler: Bu çalışmaya 1 Ocak 2023- 1 Ocak 2024 yılları arasında acil servis başvurusu sonrası yoğun bakımda takip edilen TKP tanısı alan 18 yaşından büyük 85’i kadın, 115’i erkek olmak üzere toplam 200 hasta dahil edilmiştir. Çalışmada ilk 24 saat içinde akciğer grafisi çekilen, tam kan sayımı, CRP ve albumin dahil biyokimyasal analizleri yapılan hastalar, ölenler ve hayatta kalanlar olmak üzere iki gruba ayrıldı. Gruplar arasında troponin, CRP, Albumin, ve CRP/Albümin oranlarının mortalite ile olan ilişkisi karşılaştırıldı.

Bulgular: Çalışmamızda elde edilen bulgular şu şekildedir: Mortalite gerçekleşen hastalarda troponin, CRP, Albumin ve CRP/albumin oranı değerleri anlamlı şekilde farklılaşmıştır. Troponin, CRP, albumin ve CRP/albümin oranının acil serviste mortaliteyi öngörme gücünü belirlemek için ROC analizi gerçekleştirildiğinde %82,25 ile troponin değerinin sensitivite açısından en güçlü belirteç olduğu bulunmuştur. Spesifite açısından bakıldığında albümin düşüklüğü %82,50 ile en spesifik parametre olarak tespit edilmiştir ve CRP/albümin oranı %72,50 ile albümini takip etmektedir.

Sonuç: Yoğun bakıma yatan TKP hastalarında CRP, albümin, CRP/albümin ve troponin değerinin 30 günlük mortalite açısından anlamlı birer öngörücü olduğunu düşünüyoruz.

Anahtar Kelimeler

Albümin, C-reaktif protein, CRP/ albümin, Pnömoni, Troponin

Kaynakça

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