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- Title
YKL-40, CCL18 and SP-D predict mortality in patients hospitalized with community-acquired pneumonia.
- Authors
Spoorenberg, Simone M.C.; Vestjens, Stefan M.T.; Rijkers, Ger T.; Meek, Bob; van Moorsel, Coline H.M.; Grutters, Jan C.; Bos, Willem Jan W.
- Abstract
ABSTRACT Background and objective The aim of this study was to investigate the prognostic value of four biomarkers, YKL-40, chemokine (C-C motif) ligand 18 ( CCL18), surfactant protein- D ( SP-D) and CA 15-3, in patients admitted with community-acquired pneumonia ( CAP). These markers have been studied extensively in chronic pulmonary disease, but in acute pulmonary disease their prognostic value is unknown. Methods A total of 289 adult patients who were hospitalized with CAP and participated in a randomized controlled trial were enrolled. Biomarker levels were measured on the day of admission. Intensive care unit admission, 30-day, 1-year and long-term mortality (median follow-up of 5.4 years, interquartile range ( IQR): 4.7-6.1) were recorded as outcomes. Results Median YKL-40 and CCL18 levels were significantly higher and levels of SP-D were significantly lower in CAP patients compared to healthy controls. Significantly higher YKL-40, CCL18 and SP-D levels were found in patients classified in pneumonia severity index classes 4-5 and with a CURB-65 score ≥2 compared to patients with less severe pneumonia. Furthermore, these three markers were significant predictors for long-term mortality in multivariate analysis and compared with C-reactive protein and procalcitonin level on admission, area under the curves were higher for 30-day, 1-year and long-term mortality. CA 15-3 levels were less predictive. Conclusion YKL-40, CCL18 and SP-D levels were higher in patients with more severe pneumonia, possibly reflecting the extent of pulmonary inflammation. Of these, YKL-40 most significantly predicts mortality for CAP.
- Subjects
COMMUNITY-acquired pneumonia; BIOMARKERS; GLYCOPROTEINS; CHEMOKINES; PULMONARY surfactant-associated protein D; CA 15-3 test; MULTIVARIATE analysis; PROGNOSIS
- Publication
Respirology, 2017, Vol 22, Issue 3, p542
- ISSN
1323-7799
- Publication type
Article
- DOI
10.1111/resp.12924