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. 2025 Aug 8;71(7):e20250005.
doi: 10.1590/1806-9282.20250005. eCollection 2025.

Relationship between scoring systems and inflammatory parameters with mortality in pneumonia: Acute Phase Reactant Index is new index

Emine Sarcan  1 , Ahmet Burak Erdem  1 , Sinan Özdemir  1 , Gamze Akkoyun  1 , Melike Ayas  1 , Burak Katipoğlu  1
Affiliations

Relationship between scoring systems and inflammatory parameters with mortality in pneumonia: Acute Phase Reactant Index is new index

Emine Sarcan et al. Rev Assoc Med Bras (1992). .

Abstract

Objective: The aim of this study is to investigate the relationship between risk scores and immune-inflammatory indices with prognosis and mortality in community-acquired pneumonia. Additionally, we aim to examine the association between mortality and the Acute Phase Reactant Index, which we developed using C-reactive protein, procalcitonin, and albumin levels.

Methods: This retrospective study was conducted with 417 patients diagnosed with community-acquired pneumonia who presented to the emergency department of a tertiary care hospital between 2022 and 2023. The patients' demographic data, imaging findings, blood parameters, site of care, and 30-day mortality status were recorded. Risk scores, immune-inflammatory indices, and the Acute Phase Reactant Index were calculated. The risk scores and indices were compared with treatment outcomes and 30-day mortality results.

Results: In the receiver operating characteristic analysis, Acute Phase Reactant Index was found to be as effective as other risk scores in predicting mortality. Among them, Acute Phase Reactant Index had the highest area under the curve value. Additionally, in patients transferred from the ward to the ıntensive care unit, when the Acute Phase Reactant Index score cut-off value was set at 1.32, it accurately predicted mortality in 9 out of 13 patients (69.2%).

Conclusion: It was determined that Acute Phase Reactant Index is a better predictor of mortality than all other scores and inflammatory indices in community-acquired pneumonia. This suggests that the Acute Phase Reactant Index may be used as a prognostic factor in high-mortality lung diseases such as cancer.

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Conflict of interest statement

Conflicts of interest: the authors declare there is no conflicts of interest.

Figures

Figure 1
Figure 1
(A) Receiver operating characteristic analysis of pneumonia scores and ındices for mortality. (B) Receiver operating characteristic analysis of pneumonia scores and ındices for ıntensive care unit admission. SCAP: severe community-acquired pneumonia; SII: Systemic Immune-Inflammation Index; SIRI: Systemic Inflammation Response Index; PIV: pan-ımmune-ınflammation value; SMART-COP: systolic blood pressure, multilobar involvement, albumin, respiratory rate, tachycardia, confusion, oxygenation, pH; PSI: Pneumonia Severity Index; APhRI: Acute Phase Reactant Index.
See this image and copyright information in PMC

References

    1. Aliberti S, Dela Cruz CS, Amati F, Sotgiu G, Restrepo MI. Community-acquired pneumonia. Lancet. 2021;398(10303):906–919. doi: 10.1016/S0140-6736(21)00630-9. - DOI - PubMed
    1. Ramirez JA. Overview of community-acquired pneumonia in adults. UpToDate. 2024 Available from: https://www.uptodate.com/contents/overview-of-community-acquired-pneumon... .
    1. Memon RA, Rashid MA, Avva S, Anirudh Chunchu V, Ijaz H, Ahmad Ganaie Z, et al. The use of the SMART-COP score in predicting severity outcomes among patients with community-acquired pneumonia: a meta-analysis. Cureus. 2022;14(7):e27248. doi: 10.7759/cureus.27248. - DOI - PMC - PubMed
    1. Lai CC, Chen WC, Kuo LK, Wang YT, Fu PK, Ku SC, et al. The clinical efficacy of cefoperazone-sulbactam versus piperacillin-tazobactam in the treatment of severe community-acquired pneumonia. Medicine (Baltimore) 2023;102(28):e34284. doi: 10.1097/MD.0000000000034284. - DOI - PMC - PubMed
    1. Erdem AB, Oğuztürk H, Tümer M, Işık B, Kayipmaz AE, Korkut S. Reliability of the Pneumonia Severity Score (PSI) Index in Patients Diagnosed with COVID-19 Pneumonia to Determine Outpatient Discharge. Signa Vitae. 2021;17(2):48–53. doi: 10.22514/sv.2020.16.0074. - DOI

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