19. INVESTIGATING THE CORRELATION BETWEEN NT-PROBNP AND SEVERITY ASSESSMENT INDICES PSI AND CURB-65 IN PATIENTS WITH COMMUNITY – ACQUIRED PNEUMONIA

Hoang Van Quang1,2, Tran Thanh Tung2, Duong Van Hung2, Truong Van Quoc2, Phothilard Linda2
1 Thong Nhat Hospital
2 Faculty of Medicine, Nguyen Tat Thanh University

Main Article Content

Abstract

Objective: To describe the clinical and paraclinical characteristics and to investigate the correlation between NT-ProBNP and the severity assessment indices PSI and CURB-65 in patients with community-acquired pneumonia at Thong Nhat Hospital.


Subjects and Methods: A cross-sectional descriptive study of 60 patients with communityacquired pneumonia hospitalized from January 2024 to June 2024 in the Intensive Care and Toxicology Department and the Respiratory Medicine Department.


Results: The average age was 77 ± 38 years, with males accounting for 55%. At the time of admission, the PSI score was 95.1 ± 26.1, and the CURB-65 score was 1.8 ± 0.8. The average NT-ProBNP value was 675 ± 399.6 (ng/mL). Clinical symptoms included fever (43%), cough (57%), chest pain (23%), productive cough (100%), respiratory failure (32%), and mechanical ventilation (13%). In terms of laboratory findings, 50% of patients had a white blood cell count > 12 (x 10³/µL), and 48% showed signs of lobar pneumonia on chest X-ray. NT-ProBNP had a moderate positive correlation with CURB-65 (r = 0.39; p = 0.002) and a weak positive correlation with the PSI score (r = 0.22; p = 0.095).


Conclusion: Patients with community-acquired pneumonia often present with atypical clinical symptoms, primarily lobar pneumonia. At the time of admission, NT-ProBNP had a moderate positive correlation with CURB-65 and a weak positive correlation with the PSI score. Therefore, NT-ProBNP may be considered a useful indicator for assessing severity to determine the appropriate treatment department for patients.

Article Details

References

[1] National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) 2009 - 2010.
https://www.cdc.gov/nchs/data/ahcd/combined_tables/2009-2010_combined_web_table01.pdf (Accessed on June 06, 2018).
[2] Rodriguez A, Mendia A, Sirvent JM, et al. Combination antibiotic therapy improves survival in patients with community-acquired pneumonia and shock. Crit Care Med. 2007; 35: 1493–1498.
[3] Bộ Y Tế 2020, Hướng dẫn chẩn đoán viêm phổi mắc phải cộng đồng ở người lớn. tr 7- 45
[4] Evrim Eylem Akpınar et al. Do N-terminal probrain natriuretic peptide levels determine the prognosis of community acquired pneumonia? J Bras Pneumol. 2019 Jul-Aug; 45(4): e20180417.
[5] Bin Cao et al. Diagnosis and treatment of community‐acquired pneumonia in adults: 2016 clinical practice guidelines by the Chinese Thoracic Society, Chinese Medical Association. Clin Respir J. 2018 Apr;12,1320–1360.
[6] Tạ Thị Diệu Ngân. Nghiên cứu đặc điểm lâm sàng, cận lâm sàng và căn nguyên của viêm phổi mắc phải tại cộng đồng. Luận văn tiến sĩ y học 2016, Đại học Y Hà Nội
[7] Huỳnh Định Chương, Võ Phạm Minh Thư. Đặc điểm lâm sàng, cận lâm sàng, và đánh giá thang điểm CURB-65 ở bệnh nhân viêm phổi cộng đồng, Tạp chí y dược học Cần Thơ 2023, 28: 68-76.
[8] D Hodgson, P Nee, L. Sultan. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 4: Prognostic value of B-type natriuretic peptides (BNP and NT- ProBNP) in community-acquired pneumonia. Emerg Med J, 29: 856-7, 2012
[9] Evrim Eylem Akpınar et al. Do N-terminal probrain natriuretic peptide levels determine the prognosis of community acquired pneumonia? J Bras Pneumol. 2019 Jul-Aug; 45(4): e20180417.
[10] [Dario Martolini, Eleonora Pistella, Enrico Carmenini, Claudio Santini. NT- ProBNP correlates with the illness scores pneumonia severity index and CURB-65 in patients with pneumonia. Italian Journal of Medicine 2017; volume 11:37-40
[11] Chetanya Kumar Sharma et al. Study of N-Terminal Pro B-Type Natriuretic Peptide as Predictor of Severity in Patients with Community Acquired Pneumonia. Journal of Cardiovascular Disease Research ISSN:0975-3583,0976-2833 vol12, issue 05,2021