PLoS ONE (Jan 2014)

Association of adrenal function and disease severity in community-acquired pneumonia.

  • Cornelia Mueller,
  • Claudine A Blum,
  • Michael Trummler,
  • Daiana Stolz,
  • Roland Bingisser,
  • Christian Mueller,
  • Michael Tamm,
  • Beat Mueller,
  • Philipp Schuetz,
  • Mirjam Christ-Crain

DOI
https://doi.org/10.1371/journal.pone.0099518
Journal volume & issue
Vol. 9, no. 6
p. e99518

Abstract

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IntroductionRapid and accurate risk stratification in patients with community-acquired pneumonia (CAP) is an unmet clinical need. Cortisol to dehydroepiandrosterone (DHEA) ratio was put forward as a prognostic marker in sepsis. We herein validated the prognostic value of the adrenal hormones DHEA, DHEA-Sulfate (DHEAS), cortisol/DHEA-, cortisol/DHEAS- and DHEA/DHEAS-ratios in patients with CAP.MethodsWe assessed severity of illness using the pneumonia severity index (PSI) and measured adrenal hormone concentrations in 179 serum samples of prospectively recruited patients hospitalized with CAP. We calculated spearman rank correlation, logistic regression analysis and Kaplan Meier curves to study associations of adrenal hormones and outcomes.ResultsThere was a significant correlation between PSI score and total cortisol (r = 0.24, p = 0.001), DHEAS (r = -0.23, p = 0.002), cortisol/DHEA (r = 0.23, p = 0.003), cortisol/DHEAS (r = 0.32, p = ConclusionCortisol, DHEAS and their ratios correlate with CAP severity, and cortisol and DHEA predict mortality. Adrenal function in severe pneumonia may be an important factor for CAP outcomes.