Abstract

Pneumonia is a leading cause of mortality. Severity-assessment scores in pneumonia guide treatment crucially, but the ones currently in existence are limited in their use. Community-based studies demonstrated the association between pre-existing low estimated glomerular filtration rate (eGFR) and outcomes in pneumonia. However, whether a single emergency department-eGFR measurement could predict outcomes in pneumonia remains unclear. This retrospective cohort study included 1554 patients hospitalized with pneumonia. The predictor was the first eGFR measurement. Outcomes included mortality, intensive care unit (ICU) admission, durations of hospital and ICU stay, and ventilator use. Receiver operating characteristic curves was used to determine optimal cutoff values to predict mortality. Of 1554 patients, 263 had chronic kidney disease, demonstrated higher C-reactive protein and SMART-COP scores, and had more multilobar pneumonia, acute kidney injury, ICU admission, and mortality. Patients with higher pneumonia severity scores tended to have lower eGFR. For predicting in-hospital mortality, the optimal eGFR cutoff value was 56 mL/min/1.73 m2. eGFR < 56 mL/min/1.73 m2 had an odds ratio of 2.5 (95% confidence interval, 1.6–4.0) for mortality by multivariate logistic regression. In Conclusion, eGFR < 56 mL/min/1.73 m2 is an independent predictor of mortality, indicating that even mild renal impairment affects the outcome of pneumonia adversely.

Original languageEnglish
Article number8478
JournalScientific Reports
Volume9
Issue number1
DOIs
Publication statusPublished - Dec 1 2019

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Point-of-Care Systems
Glomerular Filtration Rate
Pneumonia
Mortality
Intensive Care Units
Mechanical Ventilators
Hospital Mortality
Chronic Renal Insufficiency
Acute Kidney Injury
ROC Curve
C-Reactive Protein
Hospital Emergency Service
Cohort Studies
Retrospective Studies
Logistic Models
Odds Ratio
Confidence Intervals
Kidney

ASJC Scopus subject areas

  • General

Cite this

Point of Care eGFR and the Prediction of Outcomes in Pneumonia. / Suk, Chi won; Hsu, Shih chang; Chen, Chun you; Hsieh, Hui ling; Kuo, Hsiao tung; Hsu, Yuan pin; Sue, Yuh mou; Chen, Tso Hsiao; Lin, Feng yen; Shih, Chun ming; Chen, Jaw wen; Lin, Shing jong; Huang, Po hsun; Liu, Chung te.

In: Scientific Reports, Vol. 9, No. 1, 8478, 01.12.2019.

Research output: Contribution to journalArticle

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abstract = "Pneumonia is a leading cause of mortality. Severity-assessment scores in pneumonia guide treatment crucially, but the ones currently in existence are limited in their use. Community-based studies demonstrated the association between pre-existing low estimated glomerular filtration rate (eGFR) and outcomes in pneumonia. However, whether a single emergency department-eGFR measurement could predict outcomes in pneumonia remains unclear. This retrospective cohort study included 1554 patients hospitalized with pneumonia. The predictor was the first eGFR measurement. Outcomes included mortality, intensive care unit (ICU) admission, durations of hospital and ICU stay, and ventilator use. Receiver operating characteristic curves was used to determine optimal cutoff values to predict mortality. Of 1554 patients, 263 had chronic kidney disease, demonstrated higher C-reactive protein and SMART-COP scores, and had more multilobar pneumonia, acute kidney injury, ICU admission, and mortality. Patients with higher pneumonia severity scores tended to have lower eGFR. For predicting in-hospital mortality, the optimal eGFR cutoff value was 56 mL/min/1.73 m2. eGFR < 56 mL/min/1.73 m2 had an odds ratio of 2.5 (95{\%} confidence interval, 1.6–4.0) for mortality by multivariate logistic regression. In Conclusion, eGFR < 56 mL/min/1.73 m2 is an independent predictor of mortality, indicating that even mild renal impairment affects the outcome of pneumonia adversely.",
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AU - Hsu, Shih chang

AU - Chen, Chun you

AU - Hsieh, Hui ling

AU - Kuo, Hsiao tung

AU - Hsu, Yuan pin

AU - Sue, Yuh mou

AU - Chen, Tso Hsiao

AU - Lin, Feng yen

AU - Shih, Chun ming

AU - Chen, Jaw wen

AU - Lin, Shing jong

AU - Huang, Po hsun

AU - Liu, Chung te

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