Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Usefulness of Serum Cortisol in Assessment for the Severity of Community-Acquired Pneumonia

지역사회 획득 폐렴환자의 중증도 평가에서 혈청 코티졸의 유용성

  • Yoon, Kyung-Hwa (Department of Internal Medicine, Daegu Fatima Hospital) ;
  • Kim, Yeon-Jae (Department of Internal Medicine, Daegu Fatima Hospital) ;
  • Kim, Mi-Young (Department of Internal Medicine, Daegu Fatima Hospital) ;
  • Kim, Eun-Young (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Bae, Myoung-Nam (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Bae, Sang-Mook (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Min-Su (Department of Respiratory Medicine, Changwon Fatima Hospital) ;
  • Park, Hun-Pyo (Department of Respiratory Medicine, Changwon Fatima Hospital)
  • 윤경화 (대구파티마병원 내과) ;
  • 김연재 (대구파티마병원 내과) ;
  • 김미영 (대구파티마병원 내과) ;
  • 김은영 (가톨릭대학교 의과대학 내과학교실) ;
  • 배명남 (가톨릭대학교 의과대학 내과학교실) ;
  • 배상묵 (가톨릭대학교 의과대학 내과학교실) ;
  • 김민수 (창원파티마병원 호흡기내과) ;
  • 박훈표 (창원파티마병원 호흡기내과)
  • Received : 2010.09.14
  • Accepted : 2010.10.29
  • Published : 2010.12.30
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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 ${\geq}22.82{\mu}g/dL$, 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.

Keywords

References

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