title: Carboxy-terminal provasopressin may predict prognosis in nursing home acquired pneumonia.
abstract: BACKGROUND
  This study compares biomarker (including procalcitonin, pro-ANP, and copeptin) levels to pneumonia severity scores to predict 30-day mortality in NHAP (nursing home acquired pneumonia) patients.
  
  
  METHODS
  Seventy three patients aged ≥ 65 y, admitted to general hospitals and who fulfilled the definition of NHAP were included in the study. Data collected at admission included age, gender, nursing home admission, coexisting illness, symptoms and clinical parameters (blood pressure, pulse rate, respiratory rate and status). Additional data collected included laboratory results, radiographic findings and outcome variables. Severity of pneumonia was evaluated using a prediction rule calculated by CURB-65 criteria (confusion, urea nitrogen, respiratory rate, blood pressure, age>65 y).
  
  
  RESULTS
  After adjustment for age, sex and CURB-65, copeptin (OR=5.60, 95% confidence interval (CI)=1.20-26.24) was associated with 30-day mortality in NHAP patients, while procalcitonin and pro-ANP were not. The areas under the receiver operating characteristic curves (AUCs) for CURB-65, in predicting mortality were 0.685 [95% CI 0.559-0.811], whereas copeptin showed slightly superior accuracy with an AUC of 0.698 (95% CI 0.568-0.827).
  
  
  CONCLUSIONS
  Among 3 biomakers, copeptin was the strongest predictor of 30-day mortality from NHAP. The pathophysiologic and clinical implications of this finding require further investigation.
authors: Kwandong University College of Medicine, Gangneung-si, Gangwon-do 210-701, Republic of Korea.
authors: Sang-Hwan
authors: SH
authors: Kim
authors: Jae-Ho
authors: JH
authors: Chung
authors: Jong-Chan
authors: JC
authors: Lee
authors: Yo-Han
authors: YH
authors: Park
authors: Jun-Hyeon
authors: JH
authors: Joe
authors: Hee-Jin
authors: HJ
authors: Hwang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D009320:Atrial Natriuretic Factor / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D003428:Cross Infection / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009735:Nursing Homes; D018410:Pneumonia, Bacterial / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood; D012372:ROC Curve; D012720:Severity of Illness Index; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D006020:Glycopeptides; D011498:Protein Precursors; C048197:copeptins; D009320:Atrial Natriuretic Factor; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide