Initial inflammatory profile in community-acquired pneumonia depends on time since onset of symptoms

Raúl Méndez, Rosario Menéndez, Catia Cillóniz, Isabel Amara-Elori, Rosanel Amaro, Paula González, Tomás Posadas, Alexandra Gimeno, Pedro P. España, Jordi Almirall, Antoni Torres

Producción científica: Artículo CientíficoArtículo originalrevisión exhaustiva

35 Citas (Scopus)

Resumen

Rationale: Assessment of the inflammatory response can help the decision-making process when diagnosing community-acquired pneumonia (CAP), but there is a lack of information about the influence of time since onset of symptoms. Objectives: We studied the impact of the number of days since onset of symptoms on inflammatory cytokines and biomarker concentrations at CAP diagnosis in hospitalized patients. Methods: We performed a secondary analysis in two prospective cohorts including 541 patients in the derivation cohort and 422 in the validation cohort. The time since onset of symptoms was self-reported, and patients were classified as early presenters (,3 d) and nonearly presenters. Biomarkers (C-reactive protein [CRP] and procalcitonin [PCT] in both cohorts) and cytokines in the derivation cohort (IL-1, - 6, -8, -10, and tumor necrosis factor-a) were measured within 24 hours of hospital admission. Measurements and Main Results: In early presenters, CRP was significantly lower, whereas PCT, IL-6, and IL-8 were higher. Nonearly presenters showed significantly lower PCT, IL-6, and IL-8 levels. In the validation cohort, CRP and PCT exhibited identical patterns: CRP levels were 36.4% greater in patients with 3 or more days since onset of symptoms than in those with less than 3 days since symptom onset in the derivation cohort and 38.2% in the validation cohort. PCT levels were 40% lower in patients with 3 or more days since onset of symptoms in the derivation cohort and 56% in the validation cohort. Conclusions: Time since symptom onset modifies the systemic inflammatory profile at CAP diagnosis. This information has relevant clinical implications for management, and it should be taken into account in the design of future clinical trials.

Idioma originalInglés estadounidense
Páginas (desde-hasta)370-378
-9
PublicaciónAmerican Journal of Respiratory and Critical Care Medicine
Volumen198
N.º3
DOI
EstadoIndizado - 1 ago. 2018
Publicado de forma externa

Nota bibliográfica

Publisher Copyright:
Copyright © 2018 by the American Thoracic Society

Huella

Profundice en los temas de investigación de 'Initial inflammatory profile in community-acquired pneumonia depends on time since onset of symptoms'. En conjunto forman una huella única.

Citar esto