Your browser doesn't support javascript.
loading
Developing the Pneumonia-Optimized Ratio for Community-acquired pneumonia: An easy, inexpensive and accurate prognostic biomarker.
Cury, Vinícius Ferraz; Antoniazzi, Lucas Quadros; Oliveira, Paulo Henrique Kranz de; Borelli, Wyllians Vendramini; Cunha, Sainan Voss da; Frison, Guilherme Cristianetti; Moretto, Enrico Emerim; Seligman, Renato.
Afiliação
  • Cury VF; School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
  • Antoniazzi LQ; School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
  • Oliveira PHK; School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
  • Borelli WV; Neurology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
  • Cunha SVD; School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
  • Frison GC; School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
  • Moretto EE; School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
  • Seligman R; School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
PLoS One ; 16(3): e0248897, 2021.
Article em En | MEDLINE | ID: mdl-33755711
INTRODUCTION: Community-acquired pneumonia (CAP) is still a major public health problem. Prognostic scores at admission in tertiary services may improve early identification of severity and better allocation of resources, ultimately improving survival. Herein, we aimed at evaluating prognostic biomarkers of CAP and a Pneumonia-Optimized Ratio was created to improve prognostic performance. METHODS: In this retrospective study, all patients with suspected Community-acquired pneumonia aged 18 or older admitted to a public hospital from January 2019 to February 2020 were included in this study. Blood testing and clinical information at admission were collected, and the primary outcome was overall survival. CURB-65 scores and prognostic biomarkers were measured, namely Neutrophil-to-Lymphocyte Cell Ratio (NLCR), Platelet to Lymphocyte ratio (PLR), Monocyte to Lymphocyte Ratio (MLR). A Pneumonia-Optimized Ratio (POR) score was created by selecting the biomarker with larger accuracy (NLCR) and multiplying it by the patients' CURB-65 score. Multivariate regression model was performed and ROC curves were created for each biomarker. RESULTS: Our sample consisted of 646 individuals (median 66 years [IQR, 18-103], 53.9% females) with complete blood testing at the time of admission. Patients scored 0-1 (323, 50%), 2 (187, 28.9%), or 3 or above (122, 18.9%) in the CURB-65, and 65 (10%) presented the primary outcome of death. POR exhibited the highest Area Under Curve (AUC) in the ROC analysis (AUC = 0.753), when compared with NLCR (AUC = 0.706), PLR (AUC = 0.630) and MLR (AUC = 0.627). POR and NLCR presented increased crude mortality rate in the fourth quartile in comparison with the first quartile, and the fourth quartile of NLCR had more days of hospitalization than the first quartile (11.06±15.96 vs. 7.02±8.39, p = 0.012). CONCLUSION: The Pneumonia-Optimized Ratio in patients with CAP showed good prognostic performance of mortality at the admission of a tertiary service. The NLCR may also be used as an estimation of days of hospitalization. Prognostic biomarkers may provide important guidance to resource allocation in resource-limited settings.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia / Biomarcadores / Infecções Comunitárias Adquiridas Tipo de estudo: Guideline / Observational_studies / Prognostic_studies Limite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia / Biomarcadores / Infecções Comunitárias Adquiridas Tipo de estudo: Guideline / Observational_studies / Prognostic_studies Limite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos