Study on the utilities of the role of biomarkers like albumin, CRP, PCT and blood urea nitrogen to serum albumin (B/A) ratio in the prediction of development of complications, prognosis, and need of ICU during the course of CAP

Abstract

Context: Community-acquired pneumonia (CAP) is a serious illness. Early studies of community-acquired pneumonia reported that nonsurvivors had higher blood urea nitrogen levels and lower serum albumin levels than survivors. Therefore, elevation of the blood urea nitrogen to serum albumin (B/A) ratio may classify patients with community-acquired pneumonia who are becoming critically ill. Aim: To study the role of biomarkers in the prediction of development of complications, prognosis and need of ICU during the course of community-acquired pneumonia (CAP). Settings and Design: This is a retrospective study. Material and Method: The present study was conducted in the department of Biochemistry. 200 patient's data, required for the study was collected from the online LIS system, Chest-Medicine ward and medical ICU department. Statistical Analysis Used: Statistical analysis was performed by Pearson's correlation coefficient (r) and ROC plots. Results: B/A, PCT, and CRP are statistically significantly positively correlated with the severity of the CAP, decided on the base of PSI and CURB-65 scoring system. (Correlation coefficient r=0.7368, 0.6412 and 0.8064 respectively. P<0.0001). These biomarkers also have good sensitivity and specificity for deciding need of the ICU during the course of CAP. Conclusions: In our present study, we found an expressive and unaided positive correlation between B/A (BUN-Blood urea nitrogen/Albumin) ratio and severity of CAP. Both serum biochemical markers, blood urea nitrogen and albumin, are commonly used and can be measured promptly. Thus, our study suggests that the B/A ratio on admission can be a rapid, simple, cost-effective and predictable prognostic and severity indicator for CAP.