Prognostic value of five serum markers predicting in–hospital mortality among adults with community acquired pneumonia

To evaluate the prognostic value of serum markers predicting in–hospital mortality among community acquired pneumonia patients Methodology: Total 134 patients admitted in Sir Ganga Ram Hospital Lahore Pakistan during 2014–16 included. Serum markers recorded upon admission included blood urea nitrogen, albumin, creatinine, blood urea nitrogen/albumin ratio and blood urea nitrogen/creatinine ratio. Patients were observed for the incidence of mortality during hospitalization. Comparison between survivors and non–survivors for means by t test; odds ratios by contingency tables; and effectiveness of predictors by receiver operating characteristic curve analyses were assessed. Results: Overall mean age was 50 ± 21 years; males 45.5%; and in–hospital mortality 9.7%. For in–hospital mortality, creatinine ≥ 2.8 mg/dL showed the highest odds (OR = 7.656, 95% CI = 2.281–25.692; p = 0.001); followed by CURB-65 score ≥ 4 (OR = 4.958, 95% CI = 0.418–58.784; p = 0.266); and blood urea nitrogen ≥ 24.7 mg/dL (OR = 3.364, 95% CI = 1.033–10.954; p = 0.062). Serum creatinine was a fair predictor of in–hospital mortality (AUC = 0.721) showed 53.0% sensitivity and 87.0% specificity at cut–off 2.8 mg/dL. Blood urea nitrogen (AUC = 0.691) and blood urea nitrogen/albumin ratio (AUC = 0.675) were poor predictors; whereas albumin (AUC = 0.424) and blood urea nitrogen/creatinine ratio (AUC = 0.403) failed to predict in–hospital mortality. Conclusions: Among five serum markers, raised serum creatinine was a better predictor of in–hospital mortality in adults with community acquired pneumonia.