Utility Of Biomarkers For Evaluating The Severity Of Community-Acquired Pneumonia

Objective: The aim of this study was to investigate the role of pathogenic bacteria and six biomarkers-procalcitonin(PCT), C-reactive protein(CRP), white blood cell(WBC), erythrocyte sedimentation rate(ESR), plasma fibrinogen(FIB) and D-dimer(D-D) in the evaluation of the severity of community-acquired pneumonia.Methods: A total of 318 CAP patients hospitalized in the Department of Respiratory Diseases and Critical Care Medicine in Tongji Hospital of Tongji Medical College from January 2013 to December 2014 were enrolled in this study. PSI, CURB-65 and IDSA/ATS guidelines were used to assess the severity of CAP patients, and an analysis was performed to compare the prediction values of the biomarkers and pathogenic bacteria in CAP severity.Results: PCT, CRP, WBC and D-dimer were significantly higher in more severe group(P(27)0.05), while ESR and FIB had no significant difference in these groups(P(29)0.05). PCT, CRP, WBC and D-dimer were significantly higher in death group than those in survival group(P(27)0.05), while ESR and FIB had no significant difference in these groups(P(29)0.05). PCT, CRP, WBC and D-dimer had correlation with PSI(r=0.326, 0.195, 0.195, 0.356, P(27)0.05), and had correlation with CURB-65(r=0.297, 0.187, 0.172, 0.297, P(27)0.05). The areas under the receiver operator characteristic curve(ROC) of PCT, CRP, WBC and D-dimer were 0.792, 0.712, 0.675, 0.793, respectively. 78 strains of pathogenic microorganisms were isolated in 318 CAP patients. The positive rate of Acinetobacter baumannii was significantly higher in more severe group(P(27)0.05) and in death group.Conclusions: PCT, CRP, WBC and D-dimer could predict the severity of CAP, and PCT and D-dimer could be used as two good biomarkers to assess the severity of patients with CAP. The positive rate of Acinetobacter baumannii was significantly higher in more severe group and in death group.