Journal List > Tuberc Respir Dis > v.69(6) > 1001568

Tuberc Respir Dis. 2010 Dec;69(6):450-455. Korean.
Published online December 31, 2010.  https://doi.org/10.4046/trd.2010.69.6.450
Copyright © 2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.
Usefulness of Serum Cortisol in Assessment for the Severity of Community-Acquired Pneumonia
Min-Su Kim, M.D.,1 Hun-Pyo Park, M.D.,1 Kyung-Hwa Yoon, M.D.,2 Yeon-Jae Kim, M.D.,2 Mi-Young Kim, M.D.,2 Eun-Young Kim, M.D.,3 Myoung-Nam Bae, M.D.,3 and Sang-Mook Bae, M.D.3
1Department of Respiratory Medicine, Changwon Fatima Hospital, Changwon, Korea.
2Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea.
3Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.

Address for correspondence: Hun-Pyo Park, M.D. Department of Respiratory Medicine, Changwon Fatima Hospital, 212, Myeonseo-dong, Uichang-gu, Changwon 641-560, Korea. Phone: 82-55-270-1264, Fax: 82-55-265-7766, Email: hunpyopark@hanmail.net
Received September 14, 2010; Accepted October 29, 2010.

Abstract

Background

High cortisol levels are frequently observed in patients with severe infections are of prognostic value in sepsis. The aim of this study was to evaluate the clinical usefulness of serum cortisol in assessment for the severity of community-acquired pneumonia (CAP).

Methods

This study analyzed the results of 52 CAP subjects admitted in Changwon Fatima Hospital between July 2008 to May 2010. Total serum cortisol, infection markers such as C-reactive protein (CRP), procalcitonin (PCT) and CURB (Confusion, Uremia, Respiratory rate, Blood pressure)-65 were examined retrospectively.

Results

In clinically unstable subjects on admission day 4, baseline serum cortisol, CURB-65, and CRP were elevated significantly compared to those of stable subjects. Area under curve (AUC) of cortisol, CRP, and CURB-65 from ROC curves were 0.847, 0.783, and 0.724 respectively. In the subjects with serum cortisol ≥22.82 µg/dL, CRP, PCT, CURB-65 score, and mortality were significantly elevated.

Conclusion

These findings suggest that measurement of serum cortisol in early stage may provide helpful information in the assessment of CAP severity.

Keywords: Community acquired infections; Pneumonia; Cortisol; Severity of Illness Index; CURB-65

Figures


Figure 1
Receiver operating characteristic curves of Cortisol, CRP, and CURB-65 for predicting clinical instability after 72 h. CRP: C-reactive protein; CURB: confusion, uremia, respiratory rate, blood pressure.
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Tables


Table 1
Baseline characteristics of the 52 patients
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Table 2
Laboratory parameters and severity scores in patients with community acquired pneumonia according to outcome
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Table 3
Comparison of clinical variables in patients with community acquired pneumonia according to cortisol level
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