Tuberc Respir Dis.  2010 Dec;69(6):450-455.

Usefulness of Serum Cortisol in Assessment for the Severity of Community-Acquired Pneumonia

• Kim MS
• Park HP
• Yoon KH
• Kim YJ
• Kim MY
• Kim EY
• Bae MN
• Bae SM

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.

Keyword

Community acquired infections; Pneumonia; Cortisol; Severity of Illness Index; CURB-65

MeSH Terms

Area Under Curve
C-Reactive Protein
Calcitonin
Community-Acquired Infections
Humans
Hydrocortisone
Pneumonia
Protein Precursors
Respiratory Rate
ROC Curve
Sepsis
Severity of Illness Index
Uremia
C-Reactive Protein
Calcitonin
Hydrocortisone
Protein Precursors

Figure

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  Figure 1 Receiver operating characteristic curves of Cortisol, CRP, and CURB-65 for predicting clinical instability after 72 h. CRP: C-reactive protein; CURB: confusion, uremia, respiratory rate, blood pressure.

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