Serum suPAR associated with disease severity and mortality in elderly patients with community-acquired pneumonia

Abstract

Severe community-acquired pneumonia (SCAP) in elderly has more atypical clinical presentation compared to younger patients. Timely recognition could improve clinical care. This study investigated the value of soluble urokinase-type plasminogen activator receptor (suPAR) on severity assessment and outcome prediction in elderly patients with CAP. We conducted a prospective, observational study between January 2014 and December 2016. A total of 230 patients ≥65 were enrolled in this study, of which 151 were CAP and 79 were SCAP. Serum suPAR levels were determined by ELISA essays within 24 h after hospitalization. Thirty-day and 1-year mortalities were recorded as outcomes. Serum suPAR level was significantly increased in patients with SCAP. Positive correlation was found between suPAR levels with CURB-65 and PSI score (r = 0.423 and r = 0.489; p < .001 for both). The AUC for suPAR to discriminate SCAP patients from CAP was 0.783 at a cut-off value 4.27 ng/mL. AUCs of suPAR for predicting 30-day and 1-year mortalities were 0.815 (95% CI 0.746–0.866) and 0.820 (95% CI 0.770–0.870). Regression result shows suPAR (≥8.92 ng/mL) was independent factor for 30-day mortality (HR = 2.83, 95% CI 1.04–7.69) and suPAR with cut-off value 6.18 ng/mL could predict 1-year mortality (HR = 2.44, 95% CI 1.09–5.44). suPAR was strongly associated with CAP severity and could be a prognostic indicator for 1-year survival in elderly.

Keywords:

• suPAR
• community-acquired pneumonia
• severity
• prognosis
• elderly

Acknowledgements

The authors appreciated for the support from clinical lab in our hospital and the statistical support from North Sichuan Medical College.

Disclosure statement

The author has no conflicts of interest to declaim.

Additional information

Funding

This study was funded by the Education Department of Sichuan Province [No. 16ZB023].