Abstract
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.
Highlights
To evaluate the prognostic value of serum markers predicting in–hospital mortality among community acquired pneumonia patients Methodology: Total 134 patients admitted in Sir Ganga Ram Hospital Lahore Pakistan during 2014–16 included
The Receiver operating characteristic (ROC) curve analysis revealed serum creatinine as a fair predictor of in–hospital mortality
The present study aimed to assess the role of five serum markers including blood urea nitrogen (BUN), albumin, creatinine, BUN/albumin ratio and BUN/creatinine ratio as predictor of in–hospital mortality among Pakistani adults with Community acquired pneumonia (CAP); and found that raised serum creatinine (≥ 2.8 mg/dL) was a better predictor of in– hospital mortality among markers under investigation
Summary
Community acquired pneumonia (CAP) is one of the acute infections significantly associated with higher rate of mortality [1]. CURB– 65 (confusion, uremia, respiratory rate, blood pressure, age ≥ 65 years) score and Pneumonia Severity Index (PSI) are commonly used scales for assessing the severity of pneumonia, these scales have certain limitations such as confusion assessment error, time consuming and expensive [5,6]. For these reasons, some studies evaluated the predictive role of various biomarkers for predicting mortality in pneumonia patients. Elevated serum creatinine level was reported as an independent predictor of in–hospital mortality in severe CAP patients [7]. The present study aimed to evaluate the prognostic value of serum markers including blood urea nitrogen (BUN), albumin, creatinine, BUN/albumin ratio, and BUN/creatinine ratio for predicting in– hospital mortality among adults with CAP
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