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The role of serum markers in assessing the severity and outcome of community acquired pneumonia in Trinidadian population

Abstract

Shivananda Nayak, M. Sateesh Sakhamuri, Barry Raghunanan, Anandee Allison, Kali Uppalapati and Kishore Patcha

Our aim was to determine whether the use of serum inflammatory markers such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and procalcitonin (PCT), either individually or in combination, is significantly associated with community-acquired pneumonia and to determine the role in assessment of the severity and outcome. This study was a prospective cohort study, included forty Trinidadian patients diagnosed with community acquired pneumonia. Blood samples were collected to measure inflammatory markers. Patients were classified according to the pneumonia severity index (PSI) scoring where after serum marker levels were compared among respective groups. Proportions test for positive predictive value of the serum marker indicated that CRP (P=0.001) and ESR (P=0.001) had higher sensitivities to community acquired pneumonia than PCT (P=0.05). There was no association between each of the serum markers and PSI. Eighty three percent low risks had a length of stay of two weeks, while only 18% of high risk stayed for the same duration. The combination of highly sensitive markers like CRP and ESR and a specific marker such as PCT emphasize their importance in better risk assessment in community acquired pneumonia patients.

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