Kinetics of inflammatory biomarkers to predict one-year mortality in older patients hospitalized for pneumonia: a multivariable analysis
|Published in||International journal of infectious diseases. 2022, vol. 122, p. 63-69|
Objectives: Long-term mortality is increased in older patients with pneumonia. We aimed to test whether residual inflammation is predictive of one-year mortality after pneumonia.
Methods: Inflammation biomarkers (C-reactive protein [CRP], interleukin [IL]-6 and IL-8, tumor necrosis factor-α, serum amyloid A, neopterin, myeloperoxidase, anti-apolipoprotein A-1, and anti-phosphorylcholine IgM) were measured at admission and discharge in older patients hospitalized for pneumonia in a prospective study. Univariate and multivariate analyses were conducted using absolute level at discharge and relative and absolute differences between admission and discharge for all biomarkers, along with usual prognostic factors.
Results: In the 133 included patients (median age, 83 years [interquartile range: 78-89]), one-year mortality was 26%. In univariate analysis, the relative difference of CRP levels had the highest area under the receiver operating characteristic curve (0.70; 95% confidence interval [CI] 0.60-0.80). A decrease of CRP levels of more than 67% between admission and discharge had 68% sensitivity and 68% specificity to predict survival. In multivariate analysis, lower body mass index (hazard ratio=0.87 [CI 95% 0.79-0.96], P-value=0.01), higher IL-8 (hazard ratio=1.02 [CI 95% 1.00-1.04], P-value=0.02), and higher CRP (1.01 [95% CI 1.00-1.02], P=0.01) at discharge were independently associated with mortality.
Conclusion: Higher IL-8 and CRP levels at discharge were independently associated with one-year mortality. The relative CRP difference during hospitalization was the best individual biomarker for predicting one-year mortality.
|Keywords||Biomarkers — CRP — Elderly — IL-8 — Long-term mortality — Pneumonia — Aged — Aged, 80 and over — Biomarkers — C-Reactive Protein / analysis — Hospitalization — Humans — Inflammation — Interleukin-6 — Interleukin-8 — Pneumonia / diagnosis — Prognosis — Prospective Studies|
Article (Published version) (587 Kb) - Free access
Other version: https://www.sciencedirect.com/science/article/pii/S120197122200265X
Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences
|Research groups||Chimie et protéomique clinique (270)|
Groupe de Recherche Translationnelle en Biomarqueurs (635)
Geneva Platelet Group (13)
Groupe Perrier Arnaud (Médecine interne générale, de réhabilitation et de gériatrie) (585)
Ligue pulmonaire genevoise
Medical Directorate of Geneva University Hospitals
|MALEZIEUX, Astrid et al. Kinetics of inflammatory biomarkers to predict one-year mortality in older patients hospitalized for pneumonia: a multivariable analysis. In: International journal of infectious diseases, 2022, vol. 122, p. 63-69. doi: 10.1016/j.ijid.2022.05.002 https://archive-ouverte.unige.ch/unige:164740|