Correlation of inflammatory and cardiovascular biomarkers with pneumonia severity scores.
OBJECTIVE
To assess the correlation of procalcitonin (PCT), C-reactive protein (CRP), neopterin, mid-regional pro-atrial natriuretic peptide (MR-proANP), and mid-regional pro-adrenomedullin (MR-proADM) with severity risk scores: severe CAP (SCAP) and SMART-COP in patients with community-acquired pneumonia (CAP), as well as short term prognosis and to determine the correlation with mortality risk scores.


METHODS
Eighty-five patients with a final diagnosis of pneumonia were consecutively included during a two month period. Epidemiological, clinical, microbiological, and radiological data were recorded. Patients were stratified according to the PSI, CURB-65, SCAP and SMART-COP. Complications were defined as respiratory failure/shock, need of ICU, and death. Plasma samples were collected at admission.


RESULTS
MR-proANP and MR-proADM showed significantly higher levels in high risk SCAP group in comparison to low risk. When considering SMART-COP none of the biomarkers showed statistical differences. MR-proADM levels were high in patients with high risk of needing intensive respiratory or vasopressor support according to SMRT-CO. Neopterin and MR-proADM were significantly higher in patients that developed complications. PCT and MR-proADM showed significantly higher levels in cases of a definite bacterial diagnosis in comparison to probable bacterial, and unknown origin. MR-proANP and MR-proADM levels increased statistically according to PSI and CURB-65.


CONCLUSIONS
Biomarker levels are higher in pneumonia patients with a poorer prognosis according to SCAP and SMART-COP indexes, and to the development of complications.
Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autonòma de Barcelona, Badalona, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Spain.
Alicia
A
Lacoma
Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autonòma de Barcelona, Badalona, Spain.
Albert
A
Bas
Unitat de Curta Estada-Urgències, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autonòma de Barcelona, Badalona, Spain.
Pere
P
Tudela
Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autonòma de Barcelona, Badalona, Spain.
Montse
M
Giménez
Unitat de Curta Estada-Urgències, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autonòma de Barcelona, Badalona, Spain.
Josep Maria
JM
Mòdol
Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autonòma de Barcelona, Badalona, Spain.
Miguel
M
Pérez
Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autonòma de Barcelona, Badalona, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Spain.
Vicente
V
Ausina
Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autonòma de Barcelona, Badalona, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Spain.
Jose
J
Dominguez
Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autonòma de Barcelona, Badalona, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Spain. Electronic address: cprat.germanstrias@gencat.cat.
Cristina
C
Prat-Aymerich
D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000401:mortality; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000401:mortality; D008297:Male; D018410:Pneumonia, Bacterial / Q000097:blood* / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index
D015415:Biomarkers
Biomarcadores; Biomarkers; Neumonía; Pneumonia; Prognosis; Pronóstico; Severity scores; Índices de severidad