Blood urea nitrogen-to-serum albumin ratio and A-DROP are useful in assessing the severity of Pneumocystis pneumonia in patients without human immunodeficiency virus infection
Copyright © 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved..
INTRODUCTION: There is an increasing incidence of Pneumocystis pneumonia (PcP) among individuals without human immunodeficiency virus (HIV) infection (non-HIV PcP). However, prognostic factors for patients with non-HIV PcP have not been identified. Moreover, A-DROP (for classifying the severity of community-acquired pneumonia) or the blood urea nitrogen-to-serum albumin ratio (BUN/Alb), which is reported to be a predictor of mortality of community-acquired pneumonia, has not been established as an efficient prognostic factor in patients with non-HIV PcP. In this study, we analyzed the prognostic factors for non-HIV PcP and evaluated the prognostic ability of A-DROP and the BUN/Alb ratio.
METHODS: This retrospective study involved a chart review of the medical records of 102 patients diagnosed with non-HIV PcP between January 2003 and May 2019 at five medical facilities.
RESULTS: Overall, 102 patients were involved in this study. The 30-day mortality rate for non-HIV PcP was 20.5% in this study population. Compared with survivors, non-survivors had significantly lower serum albumin levels and significantly higher age, corticosteroid dosage at the PcP onset, alveolar-arterial oxygen gradient, A-DROP score, lactate dehydrogenase levels, blood urea nitrogen levels, and BUN/Alb ratio. Multivariate analysis showed that a high BUN/Alb ratio at treatment initiation was significantly associated with 30-day mortality risk. The receiver operating characteristic curves showed that A-DROP score had the highest prognostic ability in estimating 30-day mortality.
CONCLUSIONS: In patients with non-HIV PcP, a high BUN/Alb ratio is an independent prognostic predictor of mortality risk, and A-DROP is useful for classifying the severity.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy - 27(2021), 5 vom: 26. Mai, Seite 707-714 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Akahane, Jumpei [VerfasserIn] |
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| Links: |
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| Themen: |
A-DROP |
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| Anmerkungen: |
Date Completed 24.06.2021 Date Revised 24.06.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jiac.2020.12.017 |
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| PPN (Katalog-ID): |
NLM319401723 |
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| 245 | 1 | 0 | |a Blood urea nitrogen-to-serum albumin ratio and A-DROP are useful in assessing the severity of Pneumocystis pneumonia in patients without human immunodeficiency virus infection |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a INTRODUCTION: There is an increasing incidence of Pneumocystis pneumonia (PcP) among individuals without human immunodeficiency virus (HIV) infection (non-HIV PcP). However, prognostic factors for patients with non-HIV PcP have not been identified. Moreover, A-DROP (for classifying the severity of community-acquired pneumonia) or the blood urea nitrogen-to-serum albumin ratio (BUN/Alb), which is reported to be a predictor of mortality of community-acquired pneumonia, has not been established as an efficient prognostic factor in patients with non-HIV PcP. In this study, we analyzed the prognostic factors for non-HIV PcP and evaluated the prognostic ability of A-DROP and the BUN/Alb ratio | ||
| 520 | |a METHODS: This retrospective study involved a chart review of the medical records of 102 patients diagnosed with non-HIV PcP between January 2003 and May 2019 at five medical facilities | ||
| 520 | |a RESULTS: Overall, 102 patients were involved in this study. The 30-day mortality rate for non-HIV PcP was 20.5% in this study population. Compared with survivors, non-survivors had significantly lower serum albumin levels and significantly higher age, corticosteroid dosage at the PcP onset, alveolar-arterial oxygen gradient, A-DROP score, lactate dehydrogenase levels, blood urea nitrogen levels, and BUN/Alb ratio. Multivariate analysis showed that a high BUN/Alb ratio at treatment initiation was significantly associated with 30-day mortality risk. The receiver operating characteristic curves showed that A-DROP score had the highest prognostic ability in estimating 30-day mortality | ||
| 520 | |a CONCLUSIONS: In patients with non-HIV PcP, a high BUN/Alb ratio is an independent prognostic predictor of mortality risk, and A-DROP is useful for classifying the severity | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a A-DROP | |
| 650 | 4 | |a Blood urea nitrogen-to-serum albumin ratio | |
| 650 | 4 | |a Pneumocystis pneumonia | |
| 650 | 4 | |a Prognostic factors | |
| 650 | 7 | |a Serum Albumin |2 NLM | |
| 700 | 1 | |a Ushiki, Atsuhito |e verfasserin |4 aut | |
| 700 | 1 | |a Kosaka, Makoto |e verfasserin |4 aut | |
| 700 | 1 | |a Ikuyama, Yuichi |e verfasserin |4 aut | |
| 700 | 1 | |a Matsuo, Akemi |e verfasserin |4 aut | |
| 700 | 1 | |a Hachiya, Tsutomu |e verfasserin |4 aut | |
| 700 | 1 | |a Yoshiike, Fumiaki |e verfasserin |4 aut | |
| 700 | 1 | |a Koyama, Shigeru |e verfasserin |4 aut | |
| 700 | 1 | |a Hanaoka, Masayuki |e verfasserin |4 aut | |
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