SavedAdd your journal

Journals / Acta Medica Alanya / 2024 / Cilt: 8 Sayı: 3

Association of Troponin, C-Reactive protein, Albumin and C-Reactive protein/Albumin Ratios with Mortality in Intensive Care Unit Patients with Community-acquired Pneumonia

Toplum Kökenli Pnömonisi olan Yoğun Bakım Hastalarında Troponin, C-Reaktif protein, Albumin ve C-Reaktif protein/Albümin Oranlarının Mortalite ile İlişkisi

Nazım Onur Can(Erzurum şehir hastanesi)0000-0003-4883-3776
Şenol Arslan(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ERZURUM TIP FAKÜLTESİ, ERZURUM TIP PR.)0000-0002-6636-5307
Furkan Akpınar(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ERZURUM TIP FAKÜLTESİ, ERZURUM TIP PR.)0009-0007-2089-5437
Halil İbrahim Doru(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ERZURUM TIP FAKÜLTESİ, ERZURUM TIP PR.)0000-0001-9467-621X
Pages
189–195
Publication Date
2024-12-30
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

When ROC analysis was performed to determine the power of troponin, CRP, albumin and CRP/albumin ratio to predict mortality in the emergency department, it was found that troponin value was the strongest marker in terms of sensitivity with 82.25%.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aim: Parameters used to determine prognosis in community-acquired pneumonia (CAP) patients often have limited clinical value.
📊
Key Findings & Data:This study aims to examine the efficacy of CRP, albumin, CRP/albumin ratio and troponin elevation in predicting 30-day mortality in patients hospitalized in the intensive care unit with CAP.
💡
Conclusion & Impact:When ROC analysis was performed to determine the power of troponin, CRP, albumin and CRP/albumin ratio to predict mortality in the emergency department, it was found that troponin value was the strongest marker in terms of sensitivity with 82.25%.
🔬Design:Araştırma Makalesi
📍Scope:2023 Verileri
⚙️Variables:Albümin · C-reaktif protein · CRP/ albümin

Abstract

Aim: Parameters used to determine prognosis in community-acquired pneumonia (CAP) patients often have limited clinical value. This study aims to examine the efficacy of CRP, albumin, CRP/albumin ratio and troponin elevation in predicting 30-day mortality in patients hospitalized in the intensive care unit with CAP. Material and Methods: In this study, 200 patients (85 females and 115 males) older than 18 years of age with a diagnosis of CAP who were followed up in the intensive care unit after emergency department admission between January 1, 2023 and January 1, 2024 were included. Patients who underwent chest radiography and biochemical analyses, including complete blood count, CRP and albumin, within the first 24 hours, were divided into two groups: those who died and those who survived. Troponin, CRP, albumin, and CRP/albumin ratios were compared between the groups about mortality. Results: The findings obtained in our study were as follows: Troponin, CRP, albumin and CRP/albumin ratio values differed significantly in patients with mortality. When ROC analysis was performed to determine the power of troponin, CRP, albumin and CRP/albumin ratio to predict mortality in the emergency department, it was found that troponin value was the strongest marker in terms of sensitivity with 82.25%. In terms of specificity, low albumin was the most specific parameter, with 82.50% and CRP/albumin ratio followed albumin with 72.50%. Conclusion: We believe that CRP, albumin, CRP/albumin and troponin are significant predictors of 30 day mortality in patients with CAP hospitalized in the intensive care unit.

Özet

Amaç: Toplum kökenli pnömoni (TKP) hastalarında prognozu belirlemek için kullanılan parametreler sıklıkla sınırlı klinik değere sahiptir. Bu çalışmanın amacı TKP tanısıyla yoğun bakıma yatırılan hastalarda 30 günlük mortaliteyi öngörmede CRP, albümin, CRP/albümin oranı ve troponin yüksekliğinin etkinliğini incelemektir. Gereç ve Yöntemler: Bu çalışmaya 1 Ocak 2023- 1 Ocak 2024 yılları arasında acil servis başvurusu sonrası yoğun bakımda takip edilen TKP tanısı alan 18 yaşından büyük 85’i kadın, 115’i erkek olmak üzere toplam 200 hasta dahil edilmiştir. Çalışmada ilk 24 saat içinde akciğer grafisi çekilen, tam kan sayımı, CRP ve albumin dahil biyokimyasal analizleri yapılan hastalar, ölenler ve hayatta kalanlar olmak üzere iki gruba ayrıldı. Gruplar arasında troponin, CRP, Albumin, ve CRP/Albümin oranlarının mortalite ile olan ilişkisi karşılaştırıldı. Bulgular: Çalışmamızda elde edilen bulgular şu şekildedir: Mortalite gerçekleşen hastalarda troponin, CRP, Albumin ve CRP/albumin oranı değerleri anlamlı şekilde farklılaşmıştır. Troponin, CRP, albumin ve CRP/albümin oranının acil serviste mortaliteyi öngörme gücünü belirlemek için ROC analizi gerçekleştirildiğinde %82,25 ile troponin değerinin sensitivite açısından en güçlü belirteç olduğu bulunmuştur. Spesifite açısından bakıldığında albümin düşüklüğü %82,50 ile en spesifik parametre olarak tespit edilmiştir ve CRP/albümin oranı %72,50 ile albümini takip etmektedir. Sonuç: Yoğun bakıma yatan TKP hastalarında CRP, albümin, CRP/albümin ve troponin değerinin 30 günlük mortalite açısından anlamlı birer öngörücü olduğunu düşünüyoruz.

🔖

Cite This Article

Can, N. O., Arslan, Ş., Akpınar, F., Doru, H. İ. (2024). Association of Troponin, C-Reactive protein, Albumin and C-Reactive protein/Albumin Ratios with Mortality in Intensive Care Unit Patients with Community-acquired Pneumonia. Acta Medica Alanya, Cilt: 8 Sayı: 3, 189–195. https://doi.org/10.30565/medalanya.1525345

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (26)

  1. Musher DM, Thorner AR. Community-acquired pneumonia. N Engl J Med. 2014;371(17):1619-28. doi: 10.1056/NEJMra1312885.
  2. Christ-Crain M, Opal SM. Clinical review: the role of biomarkers in the diagnosis and management of community-acquired pneumonia. Crit Care. 2010;14(1):203. doi: 10.1186/cc8155.
  3. Ng PC, Zhao Q, Levy S, Strausberg RL, Venter JC. Individual genomes instead of race for personalized medicine. Clin Pharmacol Ther. 2008;84(3):306-9. doi: 10.1038/clpt.2008.114.
  4. Sungurlu S, Balk RA. The Role of Biomarkers in the Diagnosis and Management of Pneumonia. Clin Chest Med. 2018;39(4):691-701. doi: 10.1016/j.ccm.2018.07.004.
  5. Quah J, Jiang B, Tan PC, Siau C, Tan TY. Impact of microbial Aetiology on mortality in severe community-acquired pneumonia. BMC Infect Dis. 2018;18(1):451. doi: 10.1186/s12879-018-3366-4.
  6. Ranzani OT, Zampieri FG, Forte DN, Azevedo LC, Park M. C-reactive protein/albumin ratio predicts 90-day mortality of septic patients. PLoS One. 2013;8(3):e59321. doi: 10.1371/journal.pone.0059321.
  7. Kocatürk M, Kocatürk Ö. Assessment of relationship between C-reactive protein to albumin ratio and 90-day mortality in patients with acute ischaemic stroke. Neurol Neurochir Pol. 2019;53(3):205-11. doi: 10.5603/PJNNS.a2019.0020.
  8. Lasanianos NG, Kanakaris NK, Dimitriou R, Pape HC, Giannoudis PV. Second hit phenomenon: existing evidence of clinical implications. Injury. 2011;42(7):617-29. doi: 10.1016/j.injury.2011.02.011.
  9. Pepys MB, Hirschfield GM. C-reactive protein: a critical update. The Journal of clinical investigation. 2003;111(12):1805-12. doi: 10.1172/JCI200318921.
  10. Brack MC, Lienau J, Kuebler WM, Witzenrath M. Cardiovascular sequelae of pneumonia. Curr Opin Pulm Med. 2019;25(3):257-62. doi: 10.1097/MCP.0000000000000584.
  11. Fine MJ, Smith MA, Carson CA, Mutha SS, Sankey SS, Weissfeld LA, et al. Prognosis and outcomes of patients with community-acquired pneumonia: a meta-analysis. Jama. 1996;275(2):134-41. doi:10.1001/jama.1996.03530260048030.
  12. Fine MJ, Hough LJ, Medsger AR, Li Y-H, Ricci EM, Singer DE, et al. The hospital admission decision for patients with community-acquired pneumonia: results from the pneumonia Patient Outcomes Research Team cohort study. Archives of internal medicine. 1997;157(1):36-44. doi: 10.1001/archinte.1997.00440220040006.
  13. Buising K, Thursky K, Black J, MacGregor L, Street A, Kennedy M, et al. A prospective comparison of severity scores for identifying patients with severe community acquired pneumonia: reconsidering what is meant by severe pneumonia. Thorax. 2006;61(5):419-24. doi: 10.1136/thx.2005.051326.
  14. Laupland KB, Gregson DB, Zygun DA, Doig CJ, Mortis G, Church DL. Severe bloodstream infections: a population-based assessment. Crit Care Med. 2004;32(4):992-7. doi: 10.1097/01.CCM.0000119424.31648.1E.
  15. Collaboration ERF. C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet. 2010;375(9709):132-40. doi: 10.1016/S0140-6736(09)61717-7.
  16. Windgassen EB, Funtowicz L, Lunsford TN, Harris LA, Mulvagh SL. C-reactive protein and high-sensitivity C-reactive protein: an update for clinicians. Postgrad Med. 2011;123(1):114-9. doi: 10.3810/pgm.2011.01.2252.
  17. Artigas A, Wernerman J, Arroyo V, Vincent J-L, Levy M. Role of albumin in diseases associated with severe systemic inflammation: pathophysiologic and clinical evidence in sepsis and in decompensated cirrhosis. J Crit Care. 2016;33:62-70. doi: 10.1016/j.jcrc.2015.12.019.
  18. Kim MH, Ahn JY, Song JE, Choi H, Ann HW, Kim JK, et al. The C-reactive protein/albumin ratio as an independent predictor of mortality in patients with severe sepsis or septic shock treated with early goal-directed therapy. PloS One. 2015;10(7):e0132109. doi: 10.1371/journal.pone.0132109.
  19. Oh J, Kim SH, Park KN, Oh SH, Kim YM, Kim HJ, et al. High-sensitivity C-reactive protein/albumin ratio as a predictor of in-hospital mortality in older adults admitted to the emergency department. Clin Exp Emerg Med. 2017;4(1):19-24. doi: 10.15441/ceem.16.158.
  20. Bessière F, Khenifer S, Dubourg J, Durieu I, Lega J-C. Prognostic value of troponins in sepsis: a meta-analysis. Intensive Care Med. 2013;39(7):1181-9. doi: 10.1007/s00134-013-2902-3.
  21. Efros O, Soffer S, Leibowitz A, Fardman A, Klempfner R, Meisel E, et al. Risk factors and mortality in patients with pneumonia and elevated troponin levels. Sci Rep. 2020;10(1):21619. doi: 10.1038/s41598-020-78287-1.
  22. Oh TK, Ji E, Na H-s, Min B, Jeon Y-T, Do S-H, et al. C-reactive protein to albumin ratio predicts 30-day and 1-year mortality in postoperative patients after admission to the intensive care unit. J Clin Med. 2018;7(3):39. doi: 10.3390/jcm7030039.
  23. Özdemir S, Akça HŞ, Algın A, Eroğlu SE. Can C-reactive protein-to-albumin ratio be a predictor of short-term mortality in community-acquired pneumonia? Ann Clin Anal Med. 2021;12(9):1043-8. doi: 10.4328/ACAM.20576.
  24. Park JE, Chung KS, Song JH, Kim SY, Kim EY, Jung JY, et al. The C-reactive protein/albumin ratio as a predictor of mortality in critically ill patients. J Clin Med. 2018;7(10):333. doi: 10.3390/jcm7100333.
  25. Vestjens SM, Spoorenberg SM, Rijkers GT, Grutters JC, Ten Berg JM, Noordzij PG, et al. High‐sensitivity cardiac troponin T predicts mortality after hospitalization for community‐acquired pneumonia. Respirology. 2017;22(5):1000-6. doi: 10.1111/resp.12996.
  26. Oh TK, Ji E, Na H-s, Min B, Jeon Y-T, Do S-H, et al. C-reactive protein to albumin ratio predicts 30-day and 1-year mortality in postoperative patients after admission to the intensive care unit. J Clin Med. 2018;7(3):39. doi: 10.3390/jcm7030039.