Usefulness of plasma neutrophil gelatinase-associated lipocalin concentration for predicting the severity and mortality of patients with community-acquired pneumonia.
BACKGROUND
The usefulness of plasma neutrophil gelatinase-associated lipocalin (NGAL) concentration for predicting the outcome of community-acquired pneumonia (CAP) is unclear. We evaluated the prognostic value of plasma NGAL concentration for predicting disease severity in comparison with other widely used biological markers of inflammation in patients with CAP.


METHODS
NGAL, procalcitonin, and C-reactive protein concentrations were measured in 362 patients with CAP, who were followed for up to 30days. The Pneumonia Severity Index (PSI) and CURB-65 score were obtained for all patients.


RESULTS
The median plasma NGAL concentration increased with CAP severity classified according to the PSI. Plasma NGAL concentration was higher in nonsurvivors than in survivors. The AUC for predicting mortality was highest for NGAL concentration (0.871), followed by that for PSI (0.865) and procalcitonin concentration (0.744). Multivariable logistic regression analysis showed that plasma NGAL concentration was an independent predictor of hospital mortality in CAP patients. Plasma NGAL concentration correlated positively with C-reactive protein and procalcitonin concentrations, CURB-65 score, and PSI.


CONCLUSIONS
Plasma NGAL concentration is a valuable biological marker in the assessment of the severity and prediction of the prognosis of patients with CAP in the emergency department.
Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea. Electronic address: kuhemkjw@gmail.com.
Jong Won
JW
Kim
Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea. Electronic address: kuhemhdy@gmail.com.
Dae Young
DY
Hong
Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea. Electronic address: kuhemlkr@gmail.com.
Kyeong Ryong
KR
Lee
Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea. Electronic address: 20110096@kuh.ac.kr.
Sin Young
SY
Kim
Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea. Electronic address: kuhembkj@gmail.com.
Kwang Je
KJ
Baek
Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea. Electronic address: kuhempark@gmail.com.
Sang O
SO
Park
D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D006801:Humans; D000071068:Lipocalin-2 / Q000097:blood*; D008297:Male; D011014:Pneumonia / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D011379:Prognosis; D012044:Regression Analysis
D000071068:Lipocalin-2
Biological markers; Neutrophil gelatinase-associated lipocalin; Pneumonia, procalcitonin, prognosis