title: Usefulness and prognostic value of biomarkers in patients with community-acquired pneumonia in the emergency department.
abstract: Between all patients treated in the Emergency Department (ED), 1.35% are diagnosed with community-acquired pneumonia (CAP). CAP is the main cause of death due to infectious disease (10-14%) and the most frequent reason of sepsis-septic shock in the ED. In the last decade, the search for objective tools to help establishing an early diagnosis, bacterial aetiology, severity, suspicion of bacteremia and the prognosis of mortality has increased. Biomarkers have shown their usefulness in this matter. Procalcitonin (obtains the highest accuracy for CAP diagnosis, bacterial aetiology and the presence of bacteremia), lactate (biomarker of hypoxia and tissue hypoperfusion) and proadrenomedullin (which has the greatest accuracy to predict mortality which in combination with the prognostic severity scales obtains even better results). The aim of this review is to highlight recently published scientific evidence and to compare the utility and prognostic accuracy of the biomarkers in CAP patients treated in the ED.
authors.affiliation: Servicio de Urgencias, Complejo Hospitalario Universitario de Toledo, Toledo, España. Electronic address: agustinj@sescam.jccm.es.
authors.forename: Agustín
authors.initials: A
authors.lastname: Julián-Jiménez
authors.affiliation: Servicio de Urgencias, Hospital Universitario Clínico San Carlos, Madrid, España.
authors.forename: Juan
authors.initials: J
authors.lastname: González Del Castillo
authors.affiliation: Servicio de Microbiología Clínica, Hospital Clínico Universitario San Carlos, Madrid, España.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Candel
mesh_terms: D015415:Biomarkers / Q000378:metabolism*; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000378:metabolism; D004636:Emergency Service, Hospital; D006801:Humans; D011014:Pneumonia / Q000175:diagnosis* / Q000378:metabolism; D011379:Prognosis
chemical_list: D015415:Biomarkers
keywords: Bacteraemia; Bacteriemia; Biomarcadores; Biomarkers; C-reactive protein; Community-acquired pneumonia; Emergency department; Lactate; Lactato; Mortalidad; Mortality; Neumonía adquirida en la comunidad; Proadrenomedulina; Proadrenomedullin; Procalcitonin; Procalcitonina; Prognosis; Pronóstico; Proteína C reactiva; Servicio de urgencias