The Prognostic and Risk-Stratified Value of Heart-Type Fatty-Acid-Binding Protein in Community Acquired Pneumonia in Emergency Department

الملخص EN

Objective.

To evaluate the prognostic and risk stratified ability of heart-type fatty-acid-binding protein (H-FABP) in patients with community acquired pneumonia (CAP) in emergency department (ED) and to compare it with Pneumonia Severity Index (PSI) and CURB-65.

Methods.

Consecutive adult CAP patients admitted to the ED of Beijing Chao-Yang Hospital were enrolled.

Circulating H-FABP and troponin I were measured.

PSI and CURB-65 were calculated in all patients.

The differences in 28-day mortality and requirement for mechanical ventilation (MV) or a vasopressor within 6 h after ED arrival were compared in patients with positive H-FABP (≥7 ng/mL) and negative ones (<7 ng/mL).

Receiver operating characteristic (ROC) curve and logistic regression were used to assess the predictive value of H-FABP.

Results.

From August to November 2012, 229 CAP patients were enrolled.

The 28-day mortality, PSI, CURB-65, and incidence of using MV or a vasopressor were much higher in H-FABP-positive patients than in negative ones (P<0.01).

H-FABP was an independent predictor of the 28-day mortality.

The area under the ROC curve (AUC) of H-FABP was 0.751.

Combination of H-FABP and CURB-65 (AUC = 0.824) or H-FABP and PSI (AUC = 0.820) improved their prognostic performance.

Conclusions.

H-FABP was valuable for prognosis and risk stratification in CAP patients in ED.