Adnan Muhammad, Hashmat Naheed, Rahat Tayyaba, Burki Ayousha
Health Research Institute, National Institute of Health, Research Center FJMU, Lahore, Pakistan.
Department of Medicine, Sir Ganga Ram Hospital, Lahore, Pakistan.
J Infect Dev Ctries. 2022 Jan 31;16(1):166-172. doi: 10.3855/jidc.14495.
To evaluate the prognostic value of serum markers predicting in-hospital mortality among community acquired pneumonia patients.
Total 134 patients admitted in Sir Ganga Ram Hospital Lahore Pakistan during 2014-16 included. Serum markers recorded upon admission included blood urea nitrogen, albumin, creatinine, blood urea nitrogen/albumin ratio and blood urea nitrogen/creatinine ratio. Patients were observed for the incidence of mortality during hospitalization. Comparison between survivors and non-survivors for means by t test; odds ratios by contingency tables; and effectiveness of predictors by receiver operating characteristic curve analyses were assessed.
Overall mean age was 50 ± 21 years; males 45.5%; and in-hospital mortality 9.7%. For in-hospital mortality, creatinine ≥ 2.8 mg/dL showed the highest odds (OR = 7.656, 95% CI = 2.281-25.692; p = 0.001); followed by CURB-65 score ≥ 4 (OR = 4.958, 95% CI = 0.418-58.784; p = 0.266); and blood urea nitrogen ≥ 24.7 mg/dL (OR = 3.364, 95% CI = 1.033-10.954; p = 0.062). Serum creatinine was a fair predictor of in-hospital mortality (AUC = 0.721) showed 53.0% sensitivity and 87.0% specificity at cut-off 2.8 mg/dL. Blood urea nitrogen (AUC = 0.691) and blood urea nitrogen/albumin ratio (AUC = 0.675) were poor predictors; whereas albumin (AUC = 0.424) and blood urea nitrogen/creatinine ratio (AUC = 0.403) failed to predict in-hospital mortality.
Among five serum markers, raised serum creatinine was a better predictor of in-hospital mortality in adults with community acquired pneumonia.
评估血清标志物对社区获得性肺炎患者院内死亡率的预测价值。
纳入2014年至2016年期间在巴基斯坦拉合尔甘加拉姆爵士医院收治的134例患者。入院时记录的血清标志物包括血尿素氮、白蛋白、肌酐、血尿素氮/白蛋白比值和血尿素氮/肌酐比值。观察患者住院期间的死亡率。通过t检验比较幸存者和非幸存者的均值；通过列联表比较比值比；通过受试者工作特征曲线分析评估预测指标的有效性。
总体平均年龄为50±21岁；男性占45.5%；院内死亡率为9.7%。对于院内死亡率，肌酐≥2.8mg/dL的比值最高（OR=7.656，95%CI=2.281-25.692；p=0.001）；其次是CURB-65评分≥4（OR=4.958，95%CI=0.418-58.784；p=0.266）；血尿素氮≥24.7mg/dL（OR=3.364，95%CI=1.033-10.954；p=0.062）。血清肌酐是院内死亡率的良好预测指标（AUC=0.721），在截断值为2.8mg/dL时，敏感性为53.0%，特异性为87.0%。血尿素氮（AUC=0.691）和血尿素氮/白蛋白比值（AUC=0.675）是较差的预测指标；而白蛋白（AUC=0.424）和血尿素氮/肌酐比值（AUC=0.403）无法预测院内死亡率。
在五项血清标志物中，血清肌酐升高是社区获得性肺炎成年患者院内死亡率的较好预测指标。
