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Comparative Study
. 2017 Mar 16;12(3):e0173947.
doi: 10.1371/journal.pone.0173947. eCollection 2017.

Inflammation biomarkers in blood as mortality predictors in community-acquired pneumonia admitted patients: Importance of comparison with neutrophil count percentage or neutrophil-lymphocyte ratio

Jose Curbelo  1 , Sergio Luquero Bueno  2 , José María Galván-Román  3 , Mara Ortega-Gómez  2 , Olga Rajas  4 , Guillermo Fernández-Jiménez  5 , Lorena Vega-Piris  6 , Francisco Rodríguez-Salvanes  6 , Belén Arnalich  7 , Ana Díaz  8 , Ramón Costa  1 , Hortensia de la Fuente  3 , Ángel Lancho  3 , Carmen Suárez  1 , Julio Ancochea  4 , Javier Aspa  4
Affiliations
Comparative Study

Inflammation biomarkers in blood as mortality predictors in community-acquired pneumonia admitted patients: Importance of comparison with neutrophil count percentage or neutrophil-lymphocyte ratio

Jose Curbelo et al. PLoS One. .

Erratum in

Abstract

Introduction: The increase and persistence of inflammation in community-acquired pneumonia (CAP) patients can lead to higher mortality. Biomarkers capable of measuring this inadequate inflammatory response are likely candidates to be related with a bad outcome. We investigated the association between concentrations of several inflammatory markers and mortality of CAP patients.

Material and methods: This was a prospective study of hospitalised CAP patients in a Spanish university hospital. Blood tests upon admittance and in the early-stage evolution (72-120 hours) were carried out, where C-reactive protein, procalcitonin, proadrenomedullin, copeptin, white blood cell, Lymphocyte Count Percentage (LCP), Neutrophil Count Percentage (NCP) and Neutrophil/Lymphocyte Ratio (NLR) were measured. The outcome variable was mortality at 30 and 90 days. Statistical analysis included logistic regression, ROC analysis and area-under-curve test.

Results: 154 hospitalised CAP patients were included. Patients who died during follow-up had higher levels of procalcitonin, copeptin, proadrenomedullin, lower levels of LCP, and higher of NCP and NLR. Remarkably, multivariate analysis showed a relationship between NCP and mortality, regardless of age, severity of CAP and comorbidities. AUC analysis showed that NLR and NCP at admittance and during early-stage evolution achieved a good diagnostic power. ROC test for NCP and NLR were similar to those of the novel serum biomarkers analysed.

Conclusions: NLR and NCP, are promising candidate predictors of mortality for hospitalised CAP patients, and both are cheaper, easier to perform, and at least as reliable as the new serum biomarkers. Future implementation of new biomarkers would require comparison not only with classic inflammatory parameters like White Blood Cell count but also with NLR and NCP.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. ROC Curves of CURB65 and selected biomarkers: Neutrophil Count Percentage (NCP), Proadrenomedullin (ProADM) and Neutrophil-Lymphocyte Ratio (NLR), in Blood Test at Admittance (Upper Panels) and in Early-Stage Evolution (Lower Panels), Referred to Mortality at 30 and 90 Days.
See this image and copyright information in PMC

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