Evaluation of the clinical course of acute phase reactants and associated factors in geriatric patients followed up in icu due to community- and hospital-acquired pneumonia

Vollständiger Abstract

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Aims: Advancing age leads to numerous physiopathological changes, particularly in the respiratory system. Moreover, biomarkers and acute phase reactants are affected by age-related inflammation and cellular and humoral immunity changes. Our aim in this study was to evaluate the age-related course of acute phase reactants in CAP and HAP patients and to assess its relationship with independent intra-intensive unit (ICU) mortality. Methods: Patients followed up in intensive unit (ICU) due to community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) were evaluated retrospectively. Patients were divided into four groups in terms of age: (I) 18-64 years, (II) 65-75 years, (III) 76-90 years, and (IV) 91+ years. Acute phase reactants were measured at ICU admission and at the 72 hours after admission. Results: A total of 549 patients comprising 389 CAP and 160 HAP patients were included in the study. Mean age was 73 (range, 22-99) years and 33% of the participants were female. Age and gender were similar between the two groups. On laboratory examination, neutrophil count (NE), C-reactive protein (CRP), procalcitonin (PCT), procalcitonin and CRP were significantly higher in the HAP group than in the CAP group. The rate of intra-ICU independent mortality was significantly higher in HAP patients than in CAP patients (24.4% vs 11.6, p