Developing the pneumonia-optimized ratio for community-acquired pneumonia : an easy, inexpensive and accurate prognostic biomarker
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/220330 |
Resumo: | Introduction: Community-acquired pneumonia (CAP) is still a major public health problem. Prognostic scores at admission in tertiary services may improve early identification of severity and better allocation of resources, ultimately improving survival. Herein, we aimed at evaluating prognostic biomarkers of CAP and a Pneumonia-Optimized Ratio was created to improve prognostic performance. Methods: In this retrospective study, all patients with suspected Community-acquired pneumonia aged 18 or older admitted to a public hospital from January 2019 to February 2020 were included in this study. Blood testing and clinical information at admission were collected, and the primary outcome was overall survival. CURB-65 scores and prognostic biomarkers were measured, namely Neutrophil-to-Lymphocyte Cell Ratio (NLCR), Platelet to Lymphocyte ratio (PLR), Monocyte to Lymphocyte Ratio (MLR). A Pneumonia-Optimized Ratio (POR) score was created by selecting the biomarker with larger accuracy (NLCR) and multiplying it by the patients’ CURB-65 score. Multivariate regression model was performed and ROC curves were created for each biomarker. Results: Our sample consisted of 646 individuals (median 66 years [IQR, 18–103], 53.9% females) with complete blood testing at the time of admission. Patients scored 0–1 (323, 50%), 2 (187, 28.9%), or 3 or above (122, 18.9%) in the CURB-65, and 65 (10%) presented the primary outcome of death. POR exhibited the highest Area Under Curve (AUC) in the ROC analysis (AUC = 0.753), when compared with NLCR (AUC = 0.706), PLR (AUC = 0.630) and MLR (AUC = 0.627). POR and NLCR presented increased crude mortality rate in the fourth quartile in comparison with the first quartile, and the fourth quartile of NLCR had more days of hospitalization than the first quartile (11.06±15.96 vs. 7.02±8.39, p = 0.012). Conclusion: The Pneumonia-Optimized Ratio in patients with CAP showed good prognostic performance of mortality at the admission of a tertiary service. The NLCR may also be used as an estimation of days of hospitalization. Prognostic biomarkers may provide important guidance to resource allocation in resource-limited settings. |
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Cury, Vinicius FerrazAntoniazzi, Lucas QuadrosOliveira, Paulo Henrique Kranz deBorelli, Wyllians José VendraminiCunha, Sainan Voss daFrison, Guilherme CristianettiMoretto, Enrico EmerimSeligman, Renato2021-04-30T04:32:11Z20211932-6203http://hdl.handle.net/10183/220330001124861Introduction: Community-acquired pneumonia (CAP) is still a major public health problem. Prognostic scores at admission in tertiary services may improve early identification of severity and better allocation of resources, ultimately improving survival. Herein, we aimed at evaluating prognostic biomarkers of CAP and a Pneumonia-Optimized Ratio was created to improve prognostic performance. Methods: In this retrospective study, all patients with suspected Community-acquired pneumonia aged 18 or older admitted to a public hospital from January 2019 to February 2020 were included in this study. Blood testing and clinical information at admission were collected, and the primary outcome was overall survival. CURB-65 scores and prognostic biomarkers were measured, namely Neutrophil-to-Lymphocyte Cell Ratio (NLCR), Platelet to Lymphocyte ratio (PLR), Monocyte to Lymphocyte Ratio (MLR). A Pneumonia-Optimized Ratio (POR) score was created by selecting the biomarker with larger accuracy (NLCR) and multiplying it by the patients’ CURB-65 score. Multivariate regression model was performed and ROC curves were created for each biomarker. Results: Our sample consisted of 646 individuals (median 66 years [IQR, 18–103], 53.9% females) with complete blood testing at the time of admission. Patients scored 0–1 (323, 50%), 2 (187, 28.9%), or 3 or above (122, 18.9%) in the CURB-65, and 65 (10%) presented the primary outcome of death. POR exhibited the highest Area Under Curve (AUC) in the ROC analysis (AUC = 0.753), when compared with NLCR (AUC = 0.706), PLR (AUC = 0.630) and MLR (AUC = 0.627). POR and NLCR presented increased crude mortality rate in the fourth quartile in comparison with the first quartile, and the fourth quartile of NLCR had more days of hospitalization than the first quartile (11.06±15.96 vs. 7.02±8.39, p = 0.012). Conclusion: The Pneumonia-Optimized Ratio in patients with CAP showed good prognostic performance of mortality at the admission of a tertiary service. The NLCR may also be used as an estimation of days of hospitalization. Prognostic biomarkers may provide important guidance to resource allocation in resource-limited settings.application/pdfengPloS one. San Francisco. vol. 16, no. 3 (Mar. 2021), e0248897, 9 p.PneumoniaInfecções comunitárias adquiridasBiomarcadoresBiomarkersLymphocytesDeath ratesPneumoniaBloodNeutrophilsIntensive care unitsWhite blood cellsDeveloping the pneumonia-optimized ratio for community-acquired pneumonia : an easy, inexpensive and accurate prognostic biomarkerEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001124861.pdf.txt001124861.pdf.txtExtracted Texttext/plain29357http://www.lume.ufrgs.br/bitstream/10183/220330/2/001124861.pdf.txta37fc27eef803bf1ef103b63dae31ffdMD52ORIGINAL001124861.pdfTexto completo (inglês)application/pdf888682http://www.lume.ufrgs.br/bitstream/10183/220330/1/001124861.pdfcb4110da5a5f827cff589f587df30b2fMD5110183/2203302023-09-24 03:39:53.934376oai:www.lume.ufrgs.br:10183/220330Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2023-09-24T06:39:53Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Developing the pneumonia-optimized ratio for community-acquired pneumonia : an easy, inexpensive and accurate prognostic biomarker |
title |
Developing the pneumonia-optimized ratio for community-acquired pneumonia : an easy, inexpensive and accurate prognostic biomarker |
spellingShingle |
Developing the pneumonia-optimized ratio for community-acquired pneumonia : an easy, inexpensive and accurate prognostic biomarker Cury, Vinicius Ferraz Pneumonia Infecções comunitárias adquiridas Biomarcadores Biomarkers Lymphocytes Death rates Pneumonia Blood Neutrophils Intensive care units White blood cells |
title_short |
Developing the pneumonia-optimized ratio for community-acquired pneumonia : an easy, inexpensive and accurate prognostic biomarker |
title_full |
Developing the pneumonia-optimized ratio for community-acquired pneumonia : an easy, inexpensive and accurate prognostic biomarker |
title_fullStr |
Developing the pneumonia-optimized ratio for community-acquired pneumonia : an easy, inexpensive and accurate prognostic biomarker |
title_full_unstemmed |
Developing the pneumonia-optimized ratio for community-acquired pneumonia : an easy, inexpensive and accurate prognostic biomarker |
title_sort |
Developing the pneumonia-optimized ratio for community-acquired pneumonia : an easy, inexpensive and accurate prognostic biomarker |
author |
Cury, Vinicius Ferraz |
author_facet |
Cury, Vinicius Ferraz Antoniazzi, Lucas Quadros Oliveira, Paulo Henrique Kranz de Borelli, Wyllians José Vendramini Cunha, Sainan Voss da Frison, Guilherme Cristianetti Moretto, Enrico Emerim Seligman, Renato |
author_role |
author |
author2 |
Antoniazzi, Lucas Quadros Oliveira, Paulo Henrique Kranz de Borelli, Wyllians José Vendramini Cunha, Sainan Voss da Frison, Guilherme Cristianetti Moretto, Enrico Emerim Seligman, Renato |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Cury, Vinicius Ferraz Antoniazzi, Lucas Quadros Oliveira, Paulo Henrique Kranz de Borelli, Wyllians José Vendramini Cunha, Sainan Voss da Frison, Guilherme Cristianetti Moretto, Enrico Emerim Seligman, Renato |
dc.subject.por.fl_str_mv |
Pneumonia Infecções comunitárias adquiridas Biomarcadores |
topic |
Pneumonia Infecções comunitárias adquiridas Biomarcadores Biomarkers Lymphocytes Death rates Pneumonia Blood Neutrophils Intensive care units White blood cells |
dc.subject.eng.fl_str_mv |
Biomarkers Lymphocytes Death rates Pneumonia Blood Neutrophils Intensive care units White blood cells |
description |
Introduction: Community-acquired pneumonia (CAP) is still a major public health problem. Prognostic scores at admission in tertiary services may improve early identification of severity and better allocation of resources, ultimately improving survival. Herein, we aimed at evaluating prognostic biomarkers of CAP and a Pneumonia-Optimized Ratio was created to improve prognostic performance. Methods: In this retrospective study, all patients with suspected Community-acquired pneumonia aged 18 or older admitted to a public hospital from January 2019 to February 2020 were included in this study. Blood testing and clinical information at admission were collected, and the primary outcome was overall survival. CURB-65 scores and prognostic biomarkers were measured, namely Neutrophil-to-Lymphocyte Cell Ratio (NLCR), Platelet to Lymphocyte ratio (PLR), Monocyte to Lymphocyte Ratio (MLR). A Pneumonia-Optimized Ratio (POR) score was created by selecting the biomarker with larger accuracy (NLCR) and multiplying it by the patients’ CURB-65 score. Multivariate regression model was performed and ROC curves were created for each biomarker. Results: Our sample consisted of 646 individuals (median 66 years [IQR, 18–103], 53.9% females) with complete blood testing at the time of admission. Patients scored 0–1 (323, 50%), 2 (187, 28.9%), or 3 or above (122, 18.9%) in the CURB-65, and 65 (10%) presented the primary outcome of death. POR exhibited the highest Area Under Curve (AUC) in the ROC analysis (AUC = 0.753), when compared with NLCR (AUC = 0.706), PLR (AUC = 0.630) and MLR (AUC = 0.627). POR and NLCR presented increased crude mortality rate in the fourth quartile in comparison with the first quartile, and the fourth quartile of NLCR had more days of hospitalization than the first quartile (11.06±15.96 vs. 7.02±8.39, p = 0.012). Conclusion: The Pneumonia-Optimized Ratio in patients with CAP showed good prognostic performance of mortality at the admission of a tertiary service. The NLCR may also be used as an estimation of days of hospitalization. Prognostic biomarkers may provide important guidance to resource allocation in resource-limited settings. |
publishDate |
2021 |
dc.date.accessioned.fl_str_mv |
2021-04-30T04:32:11Z |
dc.date.issued.fl_str_mv |
2021 |
dc.type.driver.fl_str_mv |
Estrangeiro info:eu-repo/semantics/article |
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1932-6203 |
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001124861 |
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dc.relation.ispartof.pt_BR.fl_str_mv |
PloS one. San Francisco. vol. 16, no. 3 (Mar. 2021), e0248897, 9 p. |
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