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Ishiguro T, Kobayashi Y, Shimizu Y, Uemura Y, Toriba R, Takata N, Ueda M, Shimizu Y. Prognostic factors of virus-associated pneumonia other than COVID-19 in adults. Respir Med 2024; 221:107497. [PMID: 38097142 DOI: 10.1016/j.rmed.2023.107497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVE To determine prognostic factors of virus-associated pneumonia other than coronavirus disease 2019. METHODS We retrospectively studied patients suffering from virus-associated community-acquired pneumonia, and who were admitted to Saitama Cardiovascular and Respiratory Center from 2002 to 2020. Prognostic factors were analyzed by univariable and multivariable regression analysis of patient demographics, laboratory data, chest imaging, severity on admission, and initial treatment. PATIENTS HIV-positive patients, those with non-resected lung cancer or receiving chemotherapy, and those with COVID-19 were excluded. Included were 363 patients diagnosed by nucleic acid amplification method, paired sera, and rapid diagnostic tests. RESULTS A CURB-65 score of ≥3 was significant by univariable analysis for 60-day mortality but was nonsignificant by multivariable analysis. The poor prognostic factors that were significant by multivariable analysis (p < 0.05) included immunosuppressive state due to systemic corticosteroid or immunosuppressant administration, acute kidney injury on admission, and corticosteroid administration initiated within 5 days or 5 days to 2 weeks from onset. CONCLUSION A CURB-65 score of ≥3, which is considered to indicate severe pneumonia, was of limited value for predicting mortality of virus-associated pneumonia. We showed patients' underlying diseases and complications to be independent factors of poor prognosis for 60-day mortality. Timing of the initiation of corticosteroid administration remains to be elucidated.
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Affiliation(s)
- Takashi Ishiguro
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan.
| | - Yoichi Kobayashi
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
| | - Yosuke Shimizu
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukari Uemura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Riho Toriba
- Pathology, Saitama Cardiovascular and Respiratory Center, Japan
| | - Naomi Takata
- Department of Radiology, Saitama Cardiovascular and Respiratory Center, Saitama, Japan
| | - Miyuki Ueda
- Department of Radiology, Saitama Cardiovascular and Respiratory Center, Saitama, Japan
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Zhang T, Zeng Y, Lin R, Xue M, Liu M, Li Y, Zhen Y, Li N, Cao W, Wu S, Zhu H, Zhao Q, Sun B. Incorporation of Suppression of Tumorigenicity 2 into Random Survival Forests for Enhancing Prediction of Short-Term Prognosis in Community-ACQUIRED Pneumonia. J Clin Med 2022; 11:jcm11206015. [PMID: 36294336 PMCID: PMC9605170 DOI: 10.3390/jcm11206015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/10/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Biomarker and model development can help physicians adjust the management of patients with community-acquired pneumonia (CAP) by screening for inpatients with a low probability of cure early in their admission; (2) Methods: We conducted a 30-day cohort study of newly admitted adult CAP patients over 20 years of age. Prognosis models to predict the short-term prognosis were developed using random survival forest (RSF) method; (3) Results: A total of 247 adult CAP patients were studied and 208 (84.21%) of them reached clinical stability within 30 days. The soluble form of suppression of tumorigenicity-2 (sST2) was an independent predictor of clinical stability and the addition of sST2 to the prognosis model could improve the performance of the prognosis model. The C-index of the RSF model for predicting clinical stability was 0.8342 (95% CI, 0.8086–0.8598), which is higher than 0.7181 (95% CI, 0.6933–0.7429) of CURB 65 score, 0.8025 (95% CI, 0.7776–8274) of PSI score, and 0.8214 (95% CI, 0.8080–0.8348) of cox regression. In addition, the RSF model was associated with adverse clinical events during hospitalization, ICU admissions, and short-term mortality; (4) Conclusions: The RSF model by incorporating sST2 was more accurate than traditional methods in assessing the short-term prognosis of CAP patients.
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Affiliation(s)
- Teng Zhang
- Cancer Centre, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau 999078, China
- MoE Frontiers Science Center for Precision Oncology, University of Macau, Macau 999078, China
| | - Yifeng Zeng
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Runpei Lin
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Mingshan Xue
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Mingtao Liu
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Yusi Li
- Cancer Centre, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau 999078, China
| | - Yingjie Zhen
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Ning Li
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Wenhan Cao
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Sixiao Wu
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Huiqing Zhu
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Qi Zhao
- Cancer Centre, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau 999078, China
- MoE Frontiers Science Center for Precision Oncology, University of Macau, Macau 999078, China
- Correspondence: (Q.Z.); (B.S.); Tel.: +853-8822-4824 (Q.Z.); +86-138-2412-4015 (B.S.)
| | - Baoqing Sun
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
- Correspondence: (Q.Z.); (B.S.); Tel.: +853-8822-4824 (Q.Z.); +86-138-2412-4015 (B.S.)
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