Calis Aliye Gamze, Karaboga Burcu, Uzer Fatih, Kaplan Nermin, Karaca Mustafa, Gedik Rojan Barış, Durmuş Ahmet Alper
Chest Disease Clinic, Antalya Training and Research Hospital, 07100 Antalya, Turkey.
Chest Disease Clinic, Ataturk State Hospital, 07070 Antalya, Turkey.
J Clin Med. 2025 Jan 23;14(3):728. doi: 10.3390/jcm14030728.
: Community-acquired pneumonia is a major cause of morbidity and mortality, and various scoring systems and laboratory assessments are available for predicting prognosis. The untapped potential of combining the neutrophil/lymphocyte ratio (NLR) with the monocyte/lymphocyte ratio (MLR) and platelet/lymphocyte ratio (PLR) and their correlation with the pneumonia severity index (PSI) and CURB-65 motivated our research. We thought that this would provide more robust data for predicting CAP prognosis. We aimed to assess hematologic parameters' associations with the PSI, CURB-65, and qSOFA scores for predicting the prognosis of hospitalized CAP patients. DESIGN AND SETTING: This is a multicenter, observational study conducted in three hospitals in Türkiye, Antalya. : A total of 343 patients hospitalized with CAP in three centers in Turkey, Antalya, between 1 January 2020 and 30 September 2023 were retrospectively enrolled. The demographic data, comorbidities, vital signs, radiological images, laboratory findings, and 30-day mortality results of the patients were recorded. CURB-65, PSI, and qSOFA scores were calculated. : This study included 163 females (47%) with an average age of 74 ± 11.8. Hospital mortality occurred in 51 patients. Non-survivor CAP cases had higher ages ( = 0.007), CURB-65 scores ( < 0.001), PSIs ( < 0.001), and qSOFA scores ( < 0.001) and a longer hospital stay ( = 0.001) and total antibiotic duration ( < 0.001). Additionally, the NLR ( = 0.009), MLR ( = 0.018), and PLR ( = 0.025) were higher in the non-survivor group. The CURB-65, PSI, and qSOFA scores demonstrated strong predictive capabilities for in-hospital mortality. In the ROC analysis conducted to predict in-hospital mortality, the area under the curve (AUC) for CURB-65, the PSI, and qSOFA was determined to be 0.83, 0.82, and 0.82, respectively. The NLR correlated positively with CURB-65, the PSI, and qSOFA; the PLR correlated with the PSI and qSOFA; and the MLR correlated with CURB-65. : CURB-65 and PSI scores remain highly effective for predicting in-hospital mortality in CAP patients, as demonstrated by their superior AUC values. While the NLR, MLR, and PLR showed weak predictive performance compared to these scores, their correlations suggest their potential as adjunctive markers.
社区获得性肺炎是发病和死亡的主要原因，有多种评分系统和实验室评估方法可用于预测预后。将中性粒细胞/淋巴细胞比值（NLR）与单核细胞/淋巴细胞比值（MLR）和血小板/淋巴细胞比值（PLR）相结合的未开发潜力及其与肺炎严重程度指数（PSI）和CURB-65的相关性激发了我们的研究。我们认为这将为预测社区获得性肺炎的预后提供更有力的数据。我们旨在评估血液学参数与PSI、CURB-65和qSOFA评分之间的关联，以预测住院社区获得性肺炎患者的预后。设计与背景：这是一项在土耳其安塔利亚的三家医院进行的多中心观察性研究。：回顾性纳入了2020年1月1日至2023年9月30日期间在土耳其安塔利亚的三个中心因社区获得性肺炎住院的343例患者。记录了患者的人口统计学数据、合并症、生命体征、放射影像、实验室检查结果和30天死亡率结果。计算了CURB-65、PSI和qSOFA评分。：本研究包括163名女性（47%），平均年龄为74±11.8岁。51例患者发生医院死亡。非存活的社区获得性肺炎病例年龄较大（P = 0.007）、CURB-65评分较高（P < 0.001）、PSI较高（P < 0.001）、qSOFA评分较高（P < 0.001），住院时间较长（P = 0.001），总抗生素使用时间较长（P < 0.001）。此外，非存活组的NLR（P = 0.009）、MLR（P = 0.018）和PLR（P = 0.025）较高。CURB-65、PSI和qSOFA评分对院内死亡率具有较强的预测能力。在预测院内死亡率的ROC分析中，CURB-65、PSI和qSOFA的曲线下面积（AUC）分别确定为0.83、0.82和0.82。NLR与CURB-65、PSI和qSOFA呈正相关；PLR与PSI和qSOFA相关；MLR与CURB-65相关。：CURB-65和PSI评分在预测社区获得性肺炎患者的院内死亡率方面仍然非常有效，这从它们优越的AUC值可以看出。虽然与这些评分相比，NLR、MLR和PLR的预测性能较弱，但它们的相关性表明它们作为辅助标志物的潜力。
