Assessment of Mortality Risk in Patients With Community-Acquired Pneumonia: Role of Novel Inflammatory Biomarkers

社区获得性肺炎患者死亡风险评估:新型炎症生物标志物的作用

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Abstract

BACKGROUND: Pneumonia is a lung parenchyma infection with clinical presentations ranging from mild to life-threatening. Its severity depends on factors such as the causative pathogen, the host's immune response, and existing comorbidities. This study aimed to investigate the prognostic value of novel inflammatory biomarkers for predicting in-hospital mortality in patients with community-acquired pneumonia (CAP). METHODS: This retrospective cross-sectional study included 207 hospitalized patients diagnosed with clinically and radiologically confirmed pneumonia. Laboratory data collected upon admission included complete blood count parameters, C-reactive protein (CRP), creatinine, and albumin levels. Systemic inflammatory biomarkers such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), CRP-to-albumin ratio (CAR), CRP-to-lymphocyte ratio (CLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), prognostic nutritional index (PNI), and C-reactive protein-albumin-lymphocyte (CALLY) index were calculated. RESULTS: The cohort was predominantly male (69%, n = 142) with a mean age of 62.1 ± 16.3 years. The median hospital stay was 8 days, with an 11% mortality rate. Malignancy was more frequent in the nonsurvivor group (p = 0.001). Nonsurvivors had significantly lower hemoglobin (p < 0.001) and albumin (p = 0.004) levels, while CRP (p = 0.024) and creatinine (p = 0.002) were elevated. NLR (p = 0.009), CAR (p = 0.011), CLR (p = 0.006), SII (p = 0.013), and SIRI (p = 0.024) were higher in nonsurvivors, while PNI (p = 0.010) and CALLY (p = 0.003) were lower. CONCLUSION: Novel inflammatory biomarkers, particularly the CALLY index, are valuable for mortality prediction in CAP, aiding in risk stratification and early management.

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