Golcuk Y.Golcuk B.Bilge A.Korkmaz A.Irik M.Hayran M.Ozdemir A.T.Kurtulmus Y.2024-07-222024-07-22201507356757http://akademikarsiv.cbu.edu.tr:4000/handle/123456789/16227Objective This study aims to compare serum pregnancy-associated plasma protein A (PAPP-A) levels in surviving and nonsurviving elderly patients with community-acquired pneumonia (CAP), investigating whether PAPP-A is correlated with CAP prediction scores and whether PAPP-A can successfully predict 28-day mortality rates in elderly patients. Methods This prospective, observational, single-center, cross-sectional study was conducted at the emergency department (ED) of Celal Bayar University Hospital in Manisa, Turkey, between January and September 2014. All patients underwent follow-up evaluations 28 days after admission. The end point was defined as all-cause mortality. Results A total of 100 elderly patients (mean age, 77.3 ± 7.6 years [range, 65-94 years]); 60% men) with CAP were enrolled in this study. All-cause mortality at the 28-day follow-up evaluation was 22%. Admission PAPP-A levels were significantly higher in nonsurvivors compared with 28-day survivors (10.3 ± 4.5 vs 3.8 ± 2.6 ng/mL, P <.001). A significant and positive correlation between admission PAPP-A levels and pneumonia severity index; confusion, oxygen saturation, respiratory rate, blood pressure, and age 75 years or older; and confusion, urea, respiratory rate, blood pressure, and age older than 65 years scores was found (r =.440, P <.001; r =.395, P <.001; and r =.359, P <.001, respectively). Moreover, we determined that the optimal PAPP-A cutoff for predicting 28-day mortality at the time of ED admission was 5.1 ng/mL, with 77.3% sensitivity and 77.9% specificity. Conclusions Serum PAPP-A level is valuable for predicting mortality and the severity of the disease among elderly patients with CAP at ED admission. Thus, PAPP-A might play a further role in the clinical assessment of the severity of CAP. © 2015 Elsevier Inc.EnglishAge FactorsAgedAged, 80 and overCommunity-Acquired InfectionsCross-Sectional StudiesEmergency Service, HospitalFemaleHumansMalePneumoniaPredictive Value of TestsPregnancy-Associated Plasma Protein-APrognosisProspective StudiesRisk FactorsROC CurveSurvival Ratecreatininepregnancy associated plasma protein Aureapregnancy associated plasma protein AageagedArticleblood pressurebreathing ratechronic lung diseasecommunity acquired pneumoniacomorbidityconfusioncreatinine blood levelcross-sectional studyemergency wardfemalefollow upgeriatric disordergeriatric patientheart diseasehumanlung ventilationmajor clinical studymalemalignant neoplastic diseaseobservational studyoxygen saturationPneumonia Severity Indexpriority journalprognosisprospective studyprotein blood levelsurvival timesurvivorthrombocyte volumeurea blood levelurea nitrogen blood levelbloodCommunity-Acquired Infectionsemergency health servicemetabolismmortalitypneumoniapredictive valueprognosisreceiver operating characteristicrisk factorsurvival ratevery elderlyArticle10.1016/j.ajem.2015.05.047