Improving prognostication of pneumonia among elderly patients: usefulness of suPAR

Article Article scientifique Article Improving prognostication of pneumonia among elderly patients: usefulness of suPAR eng 2024-08-24 2024-08-24 author Ulaj Artida 0000-0001-8576-2749 Division of Anesthesiology, Department of Acute Medicine, Geneva University Hospital, Geneva, Switzerland. 805788 author Ibsen Arni Division of Anesthesiology, Department of Acute Medicine, Geneva University Hospital, Geneva, Switzerland. 410531 author Azurmendi Gil Leire 0000-0002-9469-9849 Department of Internal Medicine Specialties, Medical Faculty, Geneva University Hospitals, Geneva, Switzerland. 789106 Département de médecine (DEMED) author Sanchez Jean-Charles 0000-0002-8733-5932 Department of Internal Medicine Specialties, Medical Faculty, Geneva University Hospitals, Geneva, Switzerland.,Medical Faculty, Geneva, Switzerland. 24399 Département de médecine (DEMED) author Prendki Virginie 0000-0003-1315-2938 Division of Infectious Diseases, Department of Internal Medicine, Geneva University Hospital, Geneva, Switzerland.,Division of Geriatric Medicine, Department of Rehabilitation and Geriatrics Medicine, Geneva University Hospitals, Thônex, Switzerland. 811987 dept de réadaptation et gériatrie (MIGRG) author Roux Xavier 0000-0003-4356-1898 Division of Geriatric Medicine, Department of Rehabilitation and Geriatrics Medicine, Geneva University Hospitals, Thônex, Switzerland. xavier.roux@hcuge.ch.,Division of Intensive Care, Department of Acute Medicine Geneva, Geneva University Hospital, Geneva, Switzerland. xavier.roux@hcuge.ch. 848507 dept de réadaptation et gériatrie (MIGRG) 709 10.1186/s12877-024-05270-0 39182045 1471-2318 PMC11344914 https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-024-05270-0 Purpose: Elderly patients with suspected pneumonia represent a significant proportion of hospital admissions, which is a prognostic challenge for physicians. Our research aimed to assess the prognosis of patients with pneumonia using soluble urokinase plasminogen activator receptor (suPAR) combined with clinical data. Methods: In a prospective observational study including 164 patients > 65 years (mean age 84.2 (+/-7.64) years) who were hospitalized for a suspicion of pneumonia, suPAR was assessed for each patient, as was the prognosis score (PSI, CURB65) and inflammatory biomarkers (C-reactive protein, procalcitonin, white blood cells). The prognostic value of the suPAR for 30-day mortality was assessed using receiver operating characteristic (ROC) curve analyses. Optimal cut-offs with corresponding sensitivity (SE) and specificity (SP) were determined using the Youden index. Results: A suPAR > 5.1 ng/mL was predictive of 30-day mortality with a sensitivity of 100% and a specificity of 40.4%. A combination of the following parameters exhibited an SE of 100% (95% CI, 100–100) for an SP value of 64.9% (95% CI, 57.6–72.2) when at least two of them were above or below the following cut-off threshold values: suPAR > 9.8 ng/mL, BMI < 29.3 kg/m2 and PSI > 106.5. Conclusion: The suPAR seems to be a promising biomarker that can be combined with the PSI and BMI to improve the prognosis of pneumonia among elderly patients. Prospective studies with larger populations are needed to confirm whether this new approach can improve patient outcomes. Trial registration: ClinicalTrials.gov (NCT02467192), 27th may 2015. Biomarker Geriatric Mortality Pneumonia Dewey 616 Dewey 617 Dewey 618.97 56 Département de médecine 221 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 65 Département de réadaptation et gériatrie 22B false 235 Perception du Quorum et gènes de virulence 301 400 Virologie clinique 668 1255 Virus émergents 993 526 Résistance aux antibiotiques 866 369 Biomarqueurs 635 1440 Infections de la personne âgée 1062 BMC geriatrics 24 1 5a9c0b18-df2e-473d-a1f1-4d13562cf9ce Article (Published version) Public Article_scientifique_from_crossref.pdf 1437489 application/pdf CC BY-4.0 7eb1114dc9931c23185d40c0300ef2aeebb18f33414797f9bc683431418e3979 739c036b-3a49-45c7-8072-c3bbafad2fb1 Supplemental data Public 12877_2024_5270_MOESM1_ESM.docx 54318 application/vnd.openxmlformats-officedocument.wordprocessingml.document b38539c5233d0087be19d5af70046ae1c9993437425383ac1622aa55662e70bd openAccess Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences Faculté de médecine / Section de médecine clinique / Département de réadaptation et gériatrie

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