Inflammatory biomarkers are associated with aetiology and predict outcomes in community-acquired pneumonia: Results of a 5-year follow-up cohort study
Siljan, William Ward; Holter, Jan Cato; Michelsen, Annika; Nymo, Stig Haugset; Lauritzen, Trine; Oppen, Kjersti; Husebye, Einar; Ueland, Thor; Mollnes, Tom Eirik; Aukrust, Pål; Heggelund, Lars
Journal article, Peer reviewed
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http://hdl.handle.net/11250/2603636Utgivelsesdato
2019Metadata
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Sammendrag
Background Biomarkers may facilitate clinical decisions in order to guide antimicrobial treatment and prediction of prognosis in community-acquired pneumonia (CAP). We measured serum C-reactive protein, procalcitonin (PCT) and calprotectin levels, and plasma pentraxin 3 (PTX3) and presepsin levels, along with whole-blood white cell counts, at three time-points, and examined their association with microbial aetiology and adverse clinical outcomes in CAP.
Methods Blood samples were obtained at hospital admission, clinical stabilisation and 6-week follow-up from 267 hospitalised adults with CAP. Adverse short-term outcome was defined as intensive care unit admission and 30-day mortality. Long-term outcome was evaluated as 5-year all-cause mortality.
Results Peak levels of all biomarkers were seen at hospital admission. Increased admission levels of C-reactive protein, PCT and calprotectin were associated with bacterial aetiology of CAP, while increased admission levels of PCT, PTX3 and presepsin were associated with adverse short-term outcome. In univariate and multivariate regression models, white blood cells and calprotectin at 6-week follow-up were predictors of 5-year all-cause mortality.
Conclusions Calprotectin emerges as both a potential early marker of bacterial aetiology and a predictor for 5-year all-cause mortality in CAP, whereas PCT, PTX3 and presepsin may predict short-term outcome.