Chest Infections |

Predictive Power of Inflammatory Biomarkers in the Short-term Mortality in Pneumonia FREE TO VIEW

Ane Uranga, MD; Pedro Pablo España, MD; Alberto Capelastegui, PhD; Helena Azcuna, MD; Sandra Dorado, MD; Rosa Diez, RN; Urko Aguirre, MD; Maria del Carmen Mar, MD; Edurne Bereciartua, MD
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Hospital of Galdakao-Usansolo, Galdakao, Spain

Chest. 2014;145(3_MeetingAbstracts):143A. doi:10.1378/chest.1824411
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SESSION TITLE: Respiratory Infections Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: The aim of this study was to compare the ability of the relative change during the first 24h of the new biomarkers Pro adenomedullin (PADM), Procalcitonin (PCT), C-reactive protein (CRP) and Lipopolysaccharide binding protein (LBP) to predict short term mortality (hospital mortality and mortality within 30 days).

METHODS: 116 adult patients diagnosed with pneumonia were prospectively included for a period of one year. PSI score was stimated, blood samples were extracted and biomarkes analized. We defined the relative change of the studied biomarkers as the division of the difference of the values measured at Emergency Room (ER) and 24h and the records observed at ER. A positive value in the relative change of the variables between measurements in the ER and 24h means a decrease in the biomarkers. To measure the association of the relative change of the studied biomarkers with intra-hospital and 30 after discharge an unadjusted logistic regression analysis was firstly developed. To this end, mortality was the dependent variable and independent variables were biomarkers. An adjusted logistic regression analysis by the PSI index was performed afterward. Odds ratios (OR) with their confidence intervals at 95% were computed. To evaluate the discriminative power of the model, the Area Under the Curve (AUC) was calculated. All the statistical procedures were done using SAS System v9.2. A p-value <0.05 was deemed statistically significant.

RESULTS: Among the 116 patients studied, hospital mortality was 5.7% and mortality within 30 days was 8.6%. The unadjusted analysis PAMD demonstrated statistical significance either to hospital mortality or mortality within 30 days. In the adjusted analysis by PSI index, hospital mortality remains significant (p-value 0.03, AUC 0.82) and mortality within 30 days gives evidence of a clear trend to statistical significance (p value 0.07, AUC 0.81): for every 10% of reduction in this biomarker, a lower risk of mortality is shown.

CONCLUSIONS: Declining PAMD levels in the first 24 hours present lower risk of short term mortality.

CLINICAL IMPLICATIONS: Certain biomarkers, like PADM, have prognostic value in the evolution of pneumonia.

DISCLOSURE: The following authors have nothing to disclose: Ane Uranga, Pedro Pablo España, Alberto Capelastegui, Helena Azcuna, Sandra Dorado, Rosa Diez, Urko Aguirre, Maria del Carmen Mar, Edurne Bereciartua

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