Source: Annual Congress 2011 - The new clinical spectrum of lung diseases: from bronchi to pleura
Disease area: Respiratory infections

Abstract

Background: The prediction of community-acquired pneumonia (CAP) complications development may provide effective prophylaxis and prevent the lethal outcome. Aim: The improvement of prophylaxis of CAP complications development and lethal outcome on the basis of prediction by inflammation markers. Methods: 70 patients with CAP of different severity were examined. When the patient got into hospital his blood serum was tested on the level of procalcitonin (PCT) by immunochromatographic assay. Cytokines IL-2, IL-6 and TNF-α and also C-reactive protein (CRP) were identified by immune-enzyme assay. Results: The level of CRP grew alongside with the severity of CAP, the highest one was 131,5±7,6 mg/l in severe form. CRP was 1,5 times higher in patients with complicated clinical course, the highest one was 155,3±14,7 mg/l (p<0,01) at the lethal outcome. The levels of cytokines in patients with developed complications were 2 times higher than in the patients without complications. A higher level of PCT was found in patients with complicated CAP (2,36±0,20 ng/ml, p<0,01) in comparison with noncomplicated one. At the lethal outcome the level of PCT was significantly higher (3,67±0,33 ng/ml). To predict the complications development the discriminant equation was derived: D= +3,611 PCT–0,035 CRP+2,281 IL-2+0,076 IL-6+2,335 TNF-α. If D is more than or equals 15,60, the development of complications is predicted with the probability of 90,1%. Conclusions: The level of PCT, IL-2, IL-6, TNF-α, CPR increases proportionally to severity of CAP. With the help of the proposed equation it is possible to predict the development of complications from the first day of patient getting into hospital.

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V. P. Kolosov, E. Y. Kochegarova, S. V. Naryshkina (Blagoveschensk, Russian Federation). Prediction of complications development and lethal outcome in patients with community-acquired pneumonia. Eur Respir J 2011; 38: Suppl. 55, 493

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