الفهرس 
Community acquired pneumoniaOnly 14 pages are availabe for public view
 |  | from | 167 |  |  |
| | | from | 167 | | |
Abstract
ommunity – acquired pneumonia (CAP) is a serious illness, the commonest infectious cause of death and the 6th leading cause of death among diseases. Up to 40% of adults with CAP require hospital admission, hospital mortality varies between 5% and 12%. Mortality is up to 50% in those admitted in ICU.CAP managed in the community has a Mortality of 1% in outpatient clinics.
Certain serum biomarkers have been reported to predict mortality and to indicate the severity of CAP, such as serum albumin.
Albumin is the most abundant serum protein produced by the liver, serum albumin plays an important role in maintaining physiological homeostasis including maintenance of normal colloid osmotic pressure and transport of endogenous compound. In clinical practice, the serum level of albumin continues to serve as an important marker for the presence, progress and improvement of many inflammatory disease such as pneumonia.
The aim of the present study was to evaluate the prognostic value of serum albumin in community acquired pneumonia.
The study will include 50 patients who will be admitted to Abbasia chest hospital with CAP, these patients aged < 18 years who were admitted from community, didn’t have any antibiotic exposure during 14 days before coming to us, presented with anew radiographic infiltrate, and showed at least two compatible clinical symptoms (e.g., body temperature < 38oc, productive cough, chest pain, shortness of breath, crackles on auscultation).
All patients will be subjected to the following:
1-Full medical history
2-Clinical examination
3-Laboratory examination including :-
-liver function tests
-kidney function tests
-CBC
-ESR
-Serum Hs C-Reactive Protein
-Sputum analysis
-Gram stain
-Culture and sensitivity
-Serum total protein
-Serum albumin
-Fasting blood sugar
4-X – rays
5-C.T when needed
In this study, regarding demographic data of the cases included, the mean age of the patients was 50.16 years with SD ± 20.33. There was a predominance of males in the current study 82% among cases compared with 18 % females. There was a predominance of smokers 80% of cases compared with 20 % non smokers.
Patients were classified according to CURB 65 score to:
Group I: with 0-1 score the mean age of the patients was 37 years with SD ± 14.25. There was a predominance of males in the current study 86.36% among cases compared with 13.64 % females. There was a predominance of smokers 86.36% and 13.64 % non smokers.
Group I I : with 2 score the mean age of the patients was 49.08 years with SD ± 22.72. There was a predominance of males smokers in the current study 83.33% among cases compared with 16.67% females and non smokers.
Group I I I : with 3 score the mean age of the patients was 68.08 years with SD ± 7.60. There was a predominance of males in the current study 83.33% among cases compared with 16.67% females. 75% of them are smokers and25% non smokers.
Group IV: with 4 score the mean age of the patients was 72 years with SD ± 3.37. There was an equal number of males and females also smokers and non smokers are equal.
By examining the relation between patient serum albumin level and severity of CAP, the results in this study showed that there was a significant negative correlation between patient serum albumin level and severity of CAP according to CURB 65 score.
Also By examining the relation between patient serum Hs-CRP level and severity of CAP, the results in this study showed that there was a significant positive correlation between patient serum Hs-CRP level and severity of CAP according to CURB 65 score.
As levels of serum albumin decrease, the risk of complications significantly increases. Decreased albumin levels were also associated with prolonged time to reach clinical stability, prolonged hospital stay, ICU admission, the need for mechanical ventilation, and 30-day mortality.
Also elevated CRP in community-acquired pneumonia is associated with requirement for inpatient care and that higher CRP levels result in longer duration of hospital stay and poorer clinical and radiological recovery. Elevated CRP also has been shown to be associated with increased mortality in community acquired pneumonia.
In the current study there was negative significant correlation between CRP and serum albumin.
The correlation between CRP and albumin level is interesting to observe, because both are acute-phase proteins whose serum concentration changes during acute infection/ inflammation. Since CRP is a positive acute-phase protein, while albumin is a negative acute phase protein, the correlation between both is expected to be negative.