Abstract
Despite progress in intensive care, the morbidity and mortality of patients with community-acquired pneumonia (CAP) remains high. Furthermore, the predictive and prognostic utility of resistin-like molecule beta (RELM-β) in patients with CAP is uncertain. This study investigated the role of RELM-β in patients with CAP and evaluated its correlation with disease severity and the risk of death. A prospective, multicenter study was conducted in 2017, and admission serum levels of RELM-β were detected using quantitative enzyme-linked immunosorbent assay. A total of 114 and 112 patients with severe CAP (SCAP) and non-severe CAP (NSCAP) were enrolled, respectively, with 15 healthy controls. Patients with SCAP, especially non-survivors, had significantly higher levels of serum RELM-β than patients with NSCAP. RELM-β levels positively correlated with severity scores and consistently predicted SCAP in patients with CAP (area under the curve = 0.794). Increased levels of RELM-β were closely related to the severity and prognosis of patients with CAP. The accuracy of 30-day mortality predictions of CURB-65 (confusion, urea, respiratory rate, blood pressure, and age ≥ 65 years) can be significantly improved when combined with RELM-β levels. The level of RELM-β can assist clinicians in risk stratification of patients with CAP in early stages.
Highlights
Community-acquired pneumonia (CAP) is an infectious disease found worldwide [1].It has high rates of morbidity and mortality and exacts high economic costs [2]
The final study population consisted of 226 patients (114 SCAP and 112 non-severe community-acquired pneumonia (CAP) (NSCAP)
The accurate diagnosis of CAP and early assessment of severity of disease are critical in the effective management, intervention, and precise treatment of patients [2]
Summary
Community-acquired pneumonia (CAP) is an infectious disease found worldwide [1]. It has high rates of morbidity and mortality and exacts high economic costs [2]. Higher mortality rates are correlated with the inadequate treatment of outpatients and the delayed admission of patients with CAP [4]. A significant number of patients with pneumonia who eventually developed SCAP and were transferred to the intensive care unit did not show obvious severe symptoms on initial admission [5,6]. The PSI score depends on preexisting conditions and age, and CURB65 does not accurately predict mortality and poorly assesses CAP symptoms. Biomarkers can identify risks objectively, and effectively; they are helpful for clinical assessment [11,12]
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