Abstract
Context: Community-acquired pneumonia (CAP) is a serious illness. Early studies of community-acquired pneumonia reported that nonsurvivors had higher blood urea nitrogen levels and lower serum albumin levels than survivors. Therefore, elevation of the blood urea nitrogen to serum albumin (B/A) ratio may classify patients with community-acquired pneumonia who are becoming critically ill.Aim: To study the role of biomarkers in the prediction of development of complications, prognosis and need of ICU during the course of community-acquired pneumonia (CAP).Settings and Design: This is a retrospective study.Material and Method: The present study was conducted in the department of Biochemistry. 200 patients data, required for the study was collected from the online LIS system, Chest- Medicine ward and medical ICU department.Statistical Analysis Used: Statistical analysis was performed by Pearsons correlation coefficient (r) and ROC plots.Results: B/A, PCT, and CRP are statistically significantly positively correlated with the severity of the CAP, decided on the base of PSI and CURB-65 scoring system. (Correlation coefficient r=0.7368, 0.6412 and 0.8064 respectively. P<0.0001). These biomarkers also have good sensitivity and specificity for deciding need of the ICU during the course of CAP.Conclusions: In our present study, we found an expressive and unaided positive correlation between B/A (BUN-Blood urea nitrogen/Albumin) ratio and severity of CAP. Both serum biochemical markers, blood urea nitrogen and albumin, are commonly used and can be measured promptly. Thus, our study suggests that the B/A ratio on admission can be a rapid, simple, cost-effective and predictable prognostic and severity indicator for CAP.
Highlights
Community-Acquired Pneumonia (CAP), is an important cause of morbidity and mortality worldwide. [1] Pneumonia is an infection of the pulmonary parenchyma
Community-acquired pneumonia (CAP) represents a significant therapeutic trial to physicians, as they have to decide whether the patient is to be treated in a clinic or need any intensive care unit (ICU) setting
The inflammatory reaction [4,5,6] was reported as a primary reason for hypoalbuminemia. [7,8,9] The rate of the albumin synthesis is decreased in the acute phase of inflammation
Summary
Community-Acquired Pneumonia (CAP), is an important cause of morbidity and mortality worldwide. [1] Pneumonia is an infection of the pulmonary parenchyma. Community-Acquired Pneumonia (CAP), is an important cause of morbidity and mortality worldwide. Community-acquired pneumonia (CAP) represents a significant therapeutic trial to physicians, as they have to decide whether the patient is to be treated in a clinic or need any ICU setting. It is vital to assess the severity of the disease, as it forms a starting point in the management design and helps in settle agreeable patient outcomes. [2] CURB-65 (confusion, urea nitrogen, respiratory rate, blood pressure, ≥ 65 years) and Pneumonia Severity Index (PSI) are the most oftentimes used scoring scales to assess the disease severity. Hypoalbuminemia is a forecaster of poor prognosis in hospitalized and critically ill patients. [10] A high BUN level is one of the components of both the CURB65 score and PSI. BUN levels show a decrease in renal www.ssjournals.com
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