Prognostic biomarkers in predicting mortality in respiratory patients with ventilator-associated pneumonia

Abstract

Background Ventilator-associated pneumonia (VAP) is the most common nosocomial infection. Red cell distribution width (RDW) and neutrophil-lymphocyte ratio (NLR) are prognostic factors to mortality in different diseases. The aim of this study is to evaluate prognostic efficiency RDW, NLR, and the Sequential Organ Failure Assessment (SOFA) score for mortality prediction in respiratory patients with VAP. Results One hundred thirty-six patients mechanically ventilated and developed VAP were included. Clinical characteristics and SOFA score on the day of admission and at diagnosis of VAP, RDW, and NLR were assessed and correlated to mortality. The average age of patients was 58.80 ± 10.53. These variables had a good diagnostic performance for mortality prediction AUC 0.811 for SOFA at diagnosis of VAP, 0.777 for RDW, 0.728 for NLR, and 0.840 for combined of NLR and RDW. The combination of the three parameters demonstrated excellent diagnostic performance (AUC 0.889). A positive correlation was found between SOFA at diagnosis of VAP and RDW (r = 0.446, P < 0.000) and with NLR (r = 0.220, P < 0.010). Conclusions NLR and RDW are non-specific inflammatory markers that could be calculated quickly and easily via routine hemogram examination. These markers have comparable prognostic accuracy to severity scores. Consequently, RDW and NLR are simple, yet promising markers for ICU physicians in monitoring the clinical course, assessment of organ dysfunction, and predicting mortality in mechanically ventilated patients. Therefore, this study recommends the use of blood biomarkers with the one of the simplest ICU score (SOFA score) in the rapid diagnosis of critical patients as a daily works in ICU.

Predictors of In-ICU Mortality Among Older Patients with Healthcare-Associated Infection: A Cohort Study

“…This study included all bloodstream infections and did not specifically assess healthcare-associated infections. Other studies examining ventilator-associated pneumonia have found disease severity, comorbidities, and pneumonia severity as risk factors for mortality (14,15). Serum albumin levels and organ infections are linked to death in older adult patients with surgical site infections (16).…”

Ancho de distribución eritrocitaria como marcador asociado a riesgo de mortalidad en niños en cuidados intensivos

“…El impacto biológico de las enfermedades graves con variabilidad del ADE continúa en estudio, especialmente en el contexto de sepsis grave y shock séptico, donde las mediciones seriadas del ADE podrían utilizarse como factor pronóstico [20][21][22][23][24]. Así mismo, se viene investigando en COVID-19, donde podría utilizarse como un biomarcador simple y confiable para predecir la gravedad y clasificar el riesgo [25][26][27][28][29][30], y en pacientes con neumonía asociada a ventilador, donde junto al índice neutrófilo-linfocito ha demostrado correlación con mortalidad [31].…”