title: Lysophosphatidylcholine as a prognostic marker in community-acquired pneumonia requiring hospitalization: a pilot study.
abstract: Clinical prediction indicators such as the pneumonia severity index (PSI) and CURB-65 score are useful, but they are complex and often not followed. Therefore, biomarkers that improve hospital outcome predictions are emerging. This study evaluated the prognostic value of a new sepsis biomarker, serum lysophosphatidylcholine (LPC) concentrations, in community-acquired pneumonia (CAP) patients. We prospectively collected blood samples from emergency department CAP patients on days 1 and 7 (post-admission) and analyzed their plasma LPC concentrations. We retrospectively reviewed patient medical records and analyzed correlations between plasma LPC concentrations and clinical parameters and hospital outcomes. A total of 56 CAP patients were included in this study; 24 (42.9 %) required intubation and 15 (26.8 %) died. The mean LPC concentrations on days 1 (p = 0.015) and 7 (p = 0.002) of hospitalization were significantly lower in the non-survivors. Day 1 LPC concentrations were inversely correlated with the PSI (ρ = -269) and CURB-65 scores (ρ = -386). For predicting hospital mortality, the day 1 LPC concentration was comparable with the CURB-65 or PSI scores. Day 1 LPC cut-off levels <29.6 μmol/L were associated with hospital CAP outcomes, including the need for mechanical ventilation, vasopressors, intensive care unit admission, and hospital mortality. Additionally, day 7 LPC concentrations were correlated with in-hospital mortality. Initial serum LPC concentrations predicted hospital outcomes in CAP patients requiring hospitalization. These values were correlated with prognostic markers, such as the PSI and CURB-65 scores. Additionally, follow-up LPC measurements predicted the clinical course of CAP patients.
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan-si, 626-770, Korea.
authors.forename: W H
authors.initials: WH
authors.lastname: Cho
authors.forename: H J
authors.initials: HJ
authors.lastname: Yeo
authors.forename: S H
authors.initials: SH
authors.lastname: Yoon
authors.forename: S E
authors.initials: SE
authors.lastname: Lee
authors.forename: D S
authors.initials: DS
authors.lastname: Jeon
authors.forename: Y S
authors.initials: YS
authors.lastname: Kim
authors.forename: S J
authors.initials: SJ
authors.lastname: Lee
authors.forename: E J
authors.initials: EJ
authors.lastname: Jo
authors.forename: J H
authors.initials: JH
authors.lastname: Mok
authors.forename: M H
authors.initials: MH
authors.lastname: Kim
authors.forename: K U
authors.initials: KU
authors.lastname: Kim
authors.forename: K
authors.initials: K
authors.lastname: Lee
authors.forename: H K
authors.initials: HK
authors.lastname: Park
authors.forename: M K
authors.initials: MK
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D008244:Lysophosphatidylcholines / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011014:Pneumonia / Q000175:diagnosis / Q000401:mortality*; D011379:Prognosis; D056910:Republic of Korea; D012121:Respiration, Artificial; D012189:Retrospective Studies; D018805:Sepsis; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D008244:Lysophosphatidylcholines