Biomarkers for predicting short-term mortality in community-acquired pneumonia: A systematic review and meta-analysis

Viasus, Diego; Rio‐Pertuz, Gaspar Del; Simonetti, Antonella; García-Vidal, Carolina; Acosta‐Reyes, Jorge; Garavito, Argenis; Carratalà, Jordi

doi:10.1016/j.jinf.2016.01.002

Cited by 89 publications

(86 citation statements)

References 31 publications

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“…However, to improve the predictive power of these scales, different inflammatory markers have been studied such as C-reactive protein (CRP) and white blood cell count (WBC). Unfortunately, their capacity to identify patients likely to die in the long and short term is not better than that of the classic scores [9,10]. New biomarkers like procalcitonin (PCT), proadrenomedullin (proADM) and copeptin have good predictive value for mortality, at least as accurate as classic clinical scores [11–15].…”

Section: Introductionmentioning

confidence: 99%

Inflammation biomarkers in blood as mortality predictors in community-acquired pneumonia admitted patients: Importance of comparison with neutrophil count percentage or neutrophil-lymphocyte ratio

et al. 2017

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IntroductionThe increase and persistence of inflammation in community-acquired pneumonia (CAP) patients can lead to higher mortality. Biomarkers capable of measuring this inadequate inflammatory response are likely candidates to be related with a bad outcome. We investigated the association between concentrations of several inflammatory markers and mortality of CAP patients.Material and methodsThis was a prospective study of hospitalised CAP patients in a Spanish university hospital. Blood tests upon admittance and in the early-stage evolution (72–120 hours) were carried out, where C-reactive protein, procalcitonin, proadrenomedullin, copeptin, white blood cell, Lymphocyte Count Percentage (LCP), Neutrophil Count Percentage (NCP) and Neutrophil/Lymphocyte Ratio (NLR) were measured. The outcome variable was mortality at 30 and 90 days. Statistical analysis included logistic regression, ROC analysis and area-under-curve test.Results154 hospitalised CAP patients were included. Patients who died during follow-up had higher levels of procalcitonin, copeptin, proadrenomedullin, lower levels of LCP, and higher of NCP and NLR. Remarkably, multivariate analysis showed a relationship between NCP and mortality, regardless of age, severity of CAP and comorbidities. AUC analysis showed that NLR and NCP at admittance and during early-stage evolution achieved a good diagnostic power. ROC test for NCP and NLR were similar to those of the novel serum biomarkers analysed.ConclusionsNLR and NCP, are promising candidate predictors of mortality for hospitalised CAP patients, and both are cheaper, easier to perform, and at least as reliable as the new serum biomarkers. Future implementation of new biomarkers would require comparison not only with classic inflammatory parameters like White Blood Cell count but also with NLR and NCP.

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Section: Introductionmentioning

confidence: 99%

Inflammation biomarkers in blood as mortality predictors in community-acquired pneumonia admitted patients: Importance of comparison with neutrophil count percentage or neutrophil-lymphocyte ratio

et al. 2017

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“…However, because of the pulse release mode and the short half-life of AVP, the clinical application of AVP is restricted 7. Recently, as a result of the long-term stability and being easy to measure, copeptin has been used as an alternative marker of AVP and suggested as a biomarker for poor clinical outcome and mortality of some diseases, such as pneumonia,8 MI,9 diabetes,10,11 HF,12 stroke13 and transient ischemic attack 14,15…”

Section: Introductionmentioning

confidence: 99%

Prognostic role of copeptin with all-cause mortality after heart failure: a systematic review and meta-analysis

Zhang¹,

Wu²,

Li³

et al. 2017

TCRM

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BackgroundAs the C-terminal section of vasopressin precursor, copeptin has been recently suggested as a new prognostic biomarker after heart failure (HF). Thus, the aim of this study was to evaluate the prognostic value of plasma copeptin level with all-cause mortality in patients with HF.MethodsComprehensive strategies were used to search relevant studies from electronic databases. Pooled hazard ratios (HRs) and standardized mean differences (SMDs) together with their 95% confidence intervals (CIs) were calculated. Subgroup analysis and sensitivity analysis were performed to find the potential sources of heterogeneity.ResultsA total of 5,989 participants from 17 prospective studies were included in this meta-analysis. A significant association was observed between circulating copeptin levels and risk of all-cause mortality in patients with HF (categorical copeptin: HR =1.69, 95% CI =1.42–2.01; per unit copeptin: HR =1.03, 95% CI =1.00–1.07; log unit copeptin: HR =3.26, 95% CI =0.95–11.25). Pooled SMD showed that copeptin levels were significantly higher in patients with HF who died during the follow-up period than in survivors (SMD =1.19, 95% CI =0.81–1.57). Subgroup analyses also confirmed this significant association, while sensitivity analyses indicated that the overall results were stable.ConclusionThis study demonstrated that circulating copeptin seemed to be a novel biomarker to provide better prediction of all-cause mortality in patients with HF.

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“…La PCR sérica medida en la admisión al hospital se asoció al riesgo de shock séptico y uso de ventilación mecánica 35 ; sin embargo, no se asoció al riesgo de complicaciones 35,36 , admisión a UCI 37 o mortalidad en el hospital o seguimiento a 30 días como ha sido descrito en otros estudios [38][39][40][41][42][43][44] . En una revisión sistemática reciente 45 , se ha destacado que la procalcitonina, proadrenomedulina y péptido natriurético auricular séricos son mejores predictores de mortalidad en pacientes con neumonía comunitaria comparado con la PCR sérica cuya área bajo la curva receptor operador fue 0,62 (IC 95%: 0,58-0,67).…”

Section: Discussionunclassified

Utilidad de la proteína C reactiva sérica en el diagnóstico y tratamiento del adulto inmunocompetente hospitalizado por neumonía adquirida en la comunidad

Saldías-Peñafiel

Salinas-Rossel²,

Farcas-Oksenberg³

et al. 2019

Rev. méd. Chile

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Utilidad de la proteína C reactiva sérica en el diagnóstico y tratamiento del adulto inmunocompetente hospitalizado por neumonía adquirida en la comunidadFernando saldías PeñaFiel 1 , gerardo salinas rossel a , katia Farcas oksenBerg b , antonia reyes sánchez b , orlando díaz Patiño 1Immunocompetent adults hospitalized for a community-acquired pneumonia: Serum C-reactive protein as a prognostic marker Background: C-reactive protein (CRP) is used to monitor patients' response during treatment of infectious diseases. Morbidity and mortality associated with community-acquired pneumonia (CAP) is high, particularly in hospitalized patients. Better risk prediction during hospitalization could improve management and ultimately reduce mortality rates. Aim: To evaluate CRP measured at admission and the third day of hospitalization as a predictor for adverse events in CAP. Material and Methods: A prospective cohort study of adult patients hospitalized with CAP at an academic hospital. Major adverse outcomes were admission to ICU, mechanical ventilation, prolonged hospital length of stay, hospital complications and 30-day mortality. Predictive associations between CRP (as absolute levels and relative decline at third day) and adverse events were analyzed. Results: Eight hundred and twenty-three patients were assessed, 19% were admitted to ICU and 10.6% required mechanical ventilation. The average hospital stay was 8.8 ± 8.2 days, 42% had nosocomial complications and 8.1% died within 30 days. Ninety eight percent of patients had elevated serum CRP on admission to the hospital (18.1 ± 14.1 mg/dL). C-reactive protein measured at admission was associated with the risk of bacterial pneumonia, bacteremic pneumonia, septic shock and use of mechanical ventilation. Lack of CRP decline within three days of hospitalization was associated with high risk of complications, septic shock, mechanical ventilation and prolonged hospital stay. Conclusions: CRP responses at third day of hospital admission was a valuable predictor of adverse events in hospitalized CAP adult patients. (Rev Med Chile 2019; 147: 983-992)

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Biomarkers for predicting short-term mortality in community-acquired pneumonia: A systematic review and meta-analysis

Cited by 89 publications

References 31 publications

Inflammation biomarkers in blood as mortality predictors in community-acquired pneumonia admitted patients: Importance of comparison with neutrophil count percentage or neutrophil-lymphocyte ratio

Inflammation biomarkers in blood as mortality predictors in community-acquired pneumonia admitted patients: Importance of comparison with neutrophil count percentage or neutrophil-lymphocyte ratio

Prognostic role of copeptin with all-cause mortality after heart failure: a systematic review and meta-analysis

Utilidad de la proteína C reactiva sérica en el diagnóstico y tratamiento del adulto inmunocompetente hospitalizado por neumonía adquirida en la comunidad

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