Tuberc Respir Dis > Volume 69(6); 2010 > Article
Tuberculosis and Respiratory Diseases 2010;69(6):450-455.
DOI: https://doi.org/10.4046/trd.2010.69.6.450    Published online December 1, 2010.
Usefulness of Serum Cortisol in Assessment for the Severity of Community-Acquired Pneumonia.
Min Su Kim, Hun Pyo Park, Kyung Hwa Yoon, Yeon Jae Kim, Mi Young Kim, Eun Young Kim, Myoung Nam Bae, Sang Mook Bae
1Department of Respiratory Medicine, Changwon Fatima Hospital, Changwon, Korea. hunpyopark@hanmail.net
2Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea.
3Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
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 > or =22.82 microg/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.
Key Words: Community acquired infections, Pneumonia, Cortisol, Severity of Illness Index, CURB-65


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