The Acute Inflammatory Biomarkers - Are They Cost Effective and Real Time Early Predictors of Mortality in Acute Pneumonia? - A Prospective Observational Study

Abstract

Introduction: The CT chest and investigations like IL6 and TNFɑ are the most accurate blood biomarkers of inflammatory changes and can be used to stage the severity and outcome of acute pneumonia. . Getting all the above mentioned investigations in a financially poor patients is not always possible. There are not much studies to look for the association between early raise in serum acute inflammatory bio markers and the prediction of mortality in acute pneumonia. So this study is under taken to know the association between significant raise in serum acute inflammatory biomarkers like hs CRP, LDH, ferritin, NLR, WBCs count in predicting the mortality of acute pneumonia in comparison with the serum IL6,q-SOFA score and CT chest severity score. Materials & Method: All patients underwent standardized workup, including complete blood count, blood biochemistry, ferritin, hs-CRP, LDH,IL6,CT scan of chest ,q-SOFA score assessment and electrocardiogram. All the biochemical investigations were done on day 1 and day 5 of admission to the hospital. The patients were followed-up for the whole in hospital stay duration. Results: All the measured serum acute inflammatory bio markers, IL6, NLR, WBCs count, q-SOFA score and chest CT severity score were significantly elevated in patients with death due to acute pneumonia than the survived ones. [p value-0.01] Conclusion: This study proves that, the early raise in serum acute inflammatory biomarkers have got real and cost effective predictive value and are non-inferior to total WBCs count, NLR,IL6, q- SOFA score and chest CT severity score in assessing the mortality of acute pneumonia. Keywords: Acute Pneumonia, Acute inflammatory bio markers, CT scan of Chest, IL6, NLR (Neutrophils to Lymphocytes ratio), q-SOFA score, WBCs count