Background: Community-acquired pneumonia is an important cause of mortality and morbidity in all age groups. Oxidant and antioxidant mechanisms play an important role in the pathogenesis and mortality of community-acquired pneumonia. Objectives: In this study, the role of thiol/disulfide homeostasis in the diagnosis and prognosis of community-acquired pneumonia was investigated. Methods: This was a prospective, controlled, observational study involving 73 community-acquired pneumonia patients and 68 healthy volunteers. Results: The native thiol and total thiol, which are thiol/disulfide homeostasis components, were significantly lower in the community-acquired pneumonia group. It was also found that the native thiol was lower in the high-risk community-acquired pneumonia group and that the native thiol and total thiol were associated with the Pneumonia Severity Index, CRB65 (confusion, respiratory rate, blood pressure, ⩾65 years old), and CURB65 (confusion, uremia, respiratory rate, blood pressure, ⩾65 years old) scores. The thiol compound levels were also associated with the C-reactive protein and procalcitonin levels. However, there was no significant difference between the survivors and non-survivors in terms of the thiol/disulfide homeostasis parameters. Conclusion: This study demonstrated the important role that oxidative stress plays in the pathogenesis of community-acquired pneumonia. The thiol/disulfide homeostasis biomarkers especially the native thiol and index-1 levels were significantly lower in patients with community-acquired pneumonia. Further studies are needed to investigate the diagnostic and prognostic value of thiol/disulfide homeostasis parameters in community-acquired pneumonia.
Objective: The HALP Score, which is a combination of hemoglobin, albumin, lymphocytes, and platelets, is a new index that shows nutritional status and systemic inflammation, provides information about patient prognosis. In this study, we aimed to investigate the relationship of HALP score, platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR) and with poor prognosis in intensive care patients. Material and Method: Our study was designed retrospectively on patients admitted from the emergency department (ED) to the intensive care unit (ICU). HALP scores, PLR and NLR values were calculated from the hemoglobin, albumin, lymphocyte, platelet and neutrophil values taken from the patients within 24 hours. One-week and three-month mortality were determined as poor outcomes. The relationship between results and poor outcomes was investigated. Results: A total of 250 patients were included in the study. The median age of the patients was 72.5%, and 43.6% (n=109) were female. When the variables between survivors and non-survivors were compared, NLR was found to be significantly higher in non-survivors. In addition, there was a significant difference between the two groups in terms of both one-week and threemonth mortality regarding age, albumin, lymphocyte, and thrombocyte values. When we analyzed the diagnostic performances of HALP Score, NLR, and PLR for one-week and three-month mortality, only NLR showed significant diagnostic performance. The optimal cut-off point for NLR for both one-week and three-month mortality was 8.22 (for one-week mortality: AUC=0.598, p=0.007; for three-month mortality: AUC=0.592, p=0.011).
Conclusion:It was observed that the HALP score was not an effective parameter in predicting prognosis in intensive care patients. It is thought that NLR has a significant relationship with one-week and three-month mortality and can be used as an effective parameter in the prediction of prognosis in intensive care patients.
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