PT  - JOURNAL ARTICLE
AU  - William W. Siljan
AU  - Jan C. Holter
AU  - Annika E. Michelsen
AU  - Ståle H. Nymo
AU  - Trine Lauritzen
AU  - Kjersti Oppen
AU  - Einar Husebye
AU  - Thor Ueland
AU  - Tom E. Mollnes
AU  - Pål Aukrust
AU  - Lars Heggelund
TI  - Inflammatory biomarkers are associated with aetiology and predict outcomes in community-acquired pneumonia: results of a 5-year follow-up cohort study
AID  - 10.1183/23120541.00014-2019
DP  - 2019 Feb 01
TA  - ERJ Open Research
PG  - 00014-2019
VI  - 5
IP  - 1
4099  - http://openres.ersjournals.com/content/5/1/00014-2019.short
4100  - http://openres.ersjournals.com/content/5/1/00014-2019.full
SO  - erjor2019 Feb 01; 5
AB  - Background Biomarkers may facilitate clinical decisions in order to guide antimicrobial treatment and prediction of prognosis in community-acquired pneumonia (CAP). We measured serum C-reactive protein, procalcitonin (PCT) and calprotectin levels, and plasma pentraxin 3 (PTX3) and presepsin levels, along with whole-blood white cell counts, at three time-points, and examined their association with microbial aetiology and adverse clinical outcomes in CAP.Methods Blood samples were obtained at hospital admission, clinical stabilisation and 6-week follow-up from 267 hospitalised adults with CAP. Adverse short-term outcome was defined as intensive care unit admission and 30-day mortality. Long-term outcome was evaluated as 5-year all-cause mortality.Results Peak levels of all biomarkers were seen at hospital admission. Increased admission levels of C-reactive protein, PCT and calprotectin were associated with bacterial aetiology of CAP, while increased admission levels of PCT, PTX3 and presepsin were associated with adverse short-term outcome. In univariate and multivariate regression models, white blood cells and calprotectin at 6-week follow-up were predictors of 5-year all-cause mortality.Conclusions Calprotectin emerges as both a potential early marker of bacterial aetiology and a predictor for 5-year all-cause mortality in CAP, whereas PCT, PTX3 and presepsin may predict short-term outcome.In 267 adults with community-acquired pneumonia, systemic calprotectin emerges as an early marker of bacterial aetiology and a predictor of 5-year mortality, whereas systemic procalcitonin, pentraxin 3 and presepsin are predictors of short-term outcome http://ow.ly/dz6S30nAFvn