Accuracy of leptin serum level in diagnosing ventilator-associated pneumonia: a case-control study
Συγγραφέας
Parmentier-Decrucq, E.; Nseir, S.; Makris, D.; Desrousseaux, B.; Soudan, B.; Favory, R.; Mathieu, D.Ημερομηνία
2014Λέξη-κλειδί
Επιτομή
Background. Undernutrition causes a reduction of body-fat mass and a decrease in the circulating concentration of leptin which impairs the production of proinflammatory cytokines and increases the incidence of infectious diseases. The main objective of this study was to determine whether leptin deficiency is a risk factor for ventilator-associated pneumonia (VAP). Methods. This prospective observational case-control study was conducted in a university ICU during a 2-year period. Patients with VAP (cases) were matched (1:1) to patients without VAP (controls) according to all the following criteria: age, gender, SAPS II, and duration of ICU stay before VAP occurrence. In all patients leptin, C-reactive protein (CRP) and procalcitonin (PCT) were measured at ICU admission, and twice a week. In addition, in cases, leptin, CRP and PCT were also measured on the day of VAP diagnosis. Results. Eighty-six cases were matched with 86 controls. No significant difference was found in leptin and PCT levels between cases and controls. CRP level was significantly higher on the day of VAP in cases compared with controls (99 vs. 48 mg/L, P=0.001). Combination of CRP-leptin (CRP >= 78 mg/L and leptin >= 6.2 ng/mL on the day of VAP) was significantly (P=0.009) associated with VAP in univariate analysis. Multivariate analysis identified the combination of CRP-leptin (OR [95% CI] 3.08 [1.18-8.04], P=0.003), LOD score (1.27 [1.08-1.48], P=0.003), neuromuscular-blockers use (6.6 [2.03-21.7], P=0.002), and reintubation (3.3 [1.14-9.6], P=0.027) as independent risk factors for VAP. Conclusion. In our study, leptin level was not associated with VAP occurrence. Further studies are needed to confirm our results, and to define the exact inflammatory role of leptin, and its interest as a biomarker in ICU patients.
Collections
Related items
Showing items related by title, author, creator and subject.
-
A chronic alcoholic man with high fever, neck rigidity and loss of consciousness: Remember the Austrian syndrome a commonly unrecognised invasive pneumococcus triad
Georgiadou S.P., Manoulakas E., Makaritsis K.P., Dalekos G.N. (2018)Austrian syndrome is a rare medical condition characterised by the triad of pneumonia, meningitis and endocarditis due to Streptococcus pneumoniae. Native aortic valve insufficiency is the most common cause of cardiac ... -
Prehospital NSAIDs use prolong hospitalization in patients with pleuro-pulmonary infection
Kotsiou O.S., Zarogiannis S.G., Gourgoulianis K.I. (2017)Objective Nonsteroidal anti-inflammatory drug (NSAID) pre-hospitalization consumption might affect the course of pneumonia. We opted to assess the potential effects of pre-hospitalization use of NSAIDs in patients with ... -
Pneumonia with empyema among children in the first five years of high coverage with 13-valent pneumococcal conjugate vaccine
Syrogiannopoulos G.A., Michoula A.N., Tsimitselis G., Vassiou K., Chryssanthopoulou D.C., Grivea I.N. (2016)Abstract: Background: Parapneumonic effusions in children are usually associated with pneumococcal infections. In Greece, the 7-valent pneumococcal conjugate vaccine was replaced by higher-valent pneumococcal conjugate ...