Correlation of Radiology, Examination Findings and C-Reactive Protein, Sedimentation, Fibrinogen, Leukocyte Levels for Hospitalization of Patients Who Attend Chest Clinic with Infection Symptoms
Abstract
Objective:Lower respiratory tract infections such as acute bronchitis and pneumonia are commonly seen in public. History and physical examination are not always sufficient for differential diagnoses. Chest radiology is used as the initial imaging method. Acute phase reactants include proteins such as C-reactive protein (CRP) and fibrinogen which are released in response to all types of inflammation. Leukocyte count and erythrocyte sedimentation rate (ESR) are initial tests to evaluate severity of infection. Here, in this study, we searched the contribution of signs, symptoms, leukocyte count (WBC), CRP, fibrinogen, and chest X-ray in differential diagnoses of acute bronchitis and pneumonia. Materials and Methods:Patients with infection sign and symptoms applied to chest disease clinic were retrospectively analyzed between October 2011 and February 2013.Results:NTwo hundred adn fifty eight patients (162 males and 96 females) were included in the study. Mean age was 45.98±17.42 years. The subjects were classified into three groups as follows: control, acute bronchitis and pneu monia. Number of patients diagnosed as pneumonia were 39 (%15.11), as acute bronchitis 77 (%29.8) and as control 142 (%55.03). WBC, CRP, ESR and body mass index were statistically different between groups (p=0.000). There was no difference in respect to age (p=0.875) and level of fibrinogen (p=0.130). Posteroanterior chest radiography provided a statistically significant contribution in the differential diagnosis of acute bronchitis and pneumonia (p<0.05) Conclusion: WWe concluded that evaluation of CRP, WBC, ESR alltogether may contribute to diagnosis and differ ention of pneumonia and acute bronchistis
Keywords
Acute-phase reactants Bronchitis C-reactive protein Erythrocyte sedimentation rate Leukocyte Pneumonia
References
- Bülbül Y. Akut bronşit. In Özlü T, Metintaş M, Karadağ M, Kaya A, eds. Solunum Sistemi ve Hastalıkları Temel Başvuru Kitabı. İstanbul. İstanbul Tıp Kitabevi. 2010. p. 951-4.
- Özlü T. Pnömoniler. In Özlü T, Metintaş M, Karadağ M, Kaya A, eds. Solunum Sistemi ve Hastalıkları Temel Başvuru Kitabı. İstanbul. İstanbul Tıp Kitabevi, 2010. p. 813-7.
- Llor C. Acute bronchitis: aetiology and treatment. In Blasi F, Miravitlles M, eds. The Spectrum Of Bronchial Infection, European Respiratory Monograph number 60. Norwich. Page Bros Ltd. 2013. p.1-17.
- Bircan A, Kaya Ö, Münire G, Öztürk Ö, Şahin Ü, Akkaya A. Toplum kökenli pnömonilerin ağırlığının değerlendirilmesinde C-reaktif protein, lökosit sayısı ve eritrosit sedimentasyon hızının yeri. Tüberküloz ve Toraks Dergisi 2006; 54(1): 22-9.
- Kolsuz M, Metintaş M, Uçgun İ. Toplum Kökenli Pnömonilerde Hastalık Şiddeti ile Akut Faz Reaktanları Arasındaki İlişki. Tüberküloz ve Toraks Dergisi. 2002; 50 (4): 431
- Tek M, Önde G, Uğurman F, Önde U, Şipit T, Samurkaşoğlu B. Toplumsal Kaynaklı pnömoni ve koah akut atağı olan hastalarda serum crp düzeylerinin karşılaştırılması. Solunum Hastalıkları 2000;11:28-34.
- Hopstaken RM, Muris JW, Knottnerus JA, Kester AD, Rinkens PE, Dinant GJ. Contributions of symptoms, signs, erythrocyte sedimentation rate, and C-reactive protein to a diagnosis of pneumonia in acute lower respiratory tract infection. Br J Gen Pract. 2003;53(490):358-64.
- Castro-Guardiola A, Armengou-Arxé A, Viejo-Rodríguez A, Peñarroja-Matutano G, Garcia-Bragado F. Differential diagnosis between community-acquired pneumonia and non-pneumonia diseases of the chest in the emergency ward. Eur J Intern Med. 2000;11(6):334-9.
- Melbye H, Straume B, Aasebİ U, Brox J. The diagnosis of adult pneumonia in general practice. The diagnostic value of history, physical examination and some blood tests. Scand J Prim Health Care. 1988;6(2):111-7.
- Holm A, Nexoe J, Bistrup LA, Pedersen SS, Obel N, Nielsen LP et al. Aetiology and prediction of pneumonia in lower respiratory tract infection in primary care. Br J Gen Pract. 2007;57(540):547-54.
- Farah R, Makhoul N. Usefulness of various inflammatory markers to differentiate pulmonary edema from pneumonia. Isr Med Assoc J. 2011;13(4):225-9.
- Melbye H, Straume B, Aasebİ U, Dale K. Diagnosis of pneumonia in adults in general practice. Relative importance of typical symptoms and abnormal chest signs evaluated against a radiographic reference standard. Scand J Prim Health Care. 1992;10(3):226-33.
- Melbye H, Straume B, Brox J. Laboratory tests for pneumonia in general practice: the diagnostic values depend on the duration of illness. Scand J Prim Health Care. 1992;10(3):234-40.
- Seppä Y, Bloigu A, Honkanen PO, Miettinen L, Syrjälä H. Severity assessment of lower respiratory tract infection in elderly patients in primary care. Arch Intern Med. 2001;161(22):2709-13.
- García Vázquez E, Martínez JA, Mensa J, Sánchez F, Marcos MA, de Roux A et al. C-reactive protein levels in community-acquired pneumonia. Eur Respir J. 2003;21(4):702-5.
- Hopstaken RM, Cals JW, Dinant GJ. Accuracy of lipopolysaccharide-binding protein (LBP) and fibrinogen compared to C-reactive protein (CRP) in differentiating pneumonia from acute bronchitis in primary care. Prim Care Respir J. 2009;18(3):227-30.
- Tatar D, Senol G, Anar C, Tibet G. Markers of lower respiratory tract infections in emergency departments. Multidiscip Respir Med. 2013;8(1):20.
- Vilar J, Domingo ML, Soto C, Cogollos J. Radiology of bacterial pneumonia. Eur J Radiol. 2004;51(2):102-13.
- Graffelman AW, Willemssen FE, Zonderland HM, Neven AK, Kroes AC, van den Broek PJ. Limited value of chest radiography in predicting aetiology of lower respiratory tract infection in general practice. Br J Gen Pract. 2008;58(547):93-7.
- El Solh AA, Aquilina AT, Gunen H, Ramadan F. Radiographic resolution of community-acquired bacterial pneumonia in the elderly. J Am Geriatr Soc. 2004;52(2):224
- Macfarlane J, Holmes W, Gard P, Macfarlane R, Rose D, Weston V et al. Prospective study of the incidence, aetiology and outcome of adult lower respiratory tract illness in the community. Thorax. 2001;56(2):109-14.
GÖĞÜS HASTALIKLARI KLİNİĞİNE ENFEKSİYON BULGULARIYLA BAŞVURAN HASTALARIN C-REAKTİF PROTEİN, SEDİMENTASYON, FİBRİNOJEN, LÖKOSİT DÜZEYLERİNİN, MUAYENE BULGULARININ VE RADYOLOJİNİN HASTANEYE YATIRMADA KORELASYONU
Abstract
Amaç: Akut bronşit ve pnömoniyi kapsayan alt solunum yolu enfeksiyonları toplumda sık görülmektedir. Öykü ve fiziki muayene ayırıcı tanıyı yapmak için her zaman yeterli olmamaktadır. Akciğer radyolojisi ilk basamakta kullanılan görüntüleme yöntemidir. Akut faz reaktanları her tip inflamatuvar süreçte salınan proteinlerdir, C-reaktif protein ve fibrinojen başlıcalarıdır. Lökosit sayısı (WBC) ve eritrosit sedimentasyon hızı(ESH) enfeksiyonun şiddetini belirlemede ilk istenen testlerdir. Bu çalışmada hastanın kliniği, semptom ve fiziki muayenesi, lökosit (WBC), eritrosit sedimentasyon hızı (ESH) ve C-reaktif protein (CRP), fibrinojen ve akciğer grafisinin pnömoni ve akut bronşit ayrımına olan katkısını araştırdık. Gereç ve Yöntemler: Ekim 2011-Şubat 2013 tarihleri arasında göğüs hastalıkları kliniğine enfeksiyon bulgularıyla başvuran hastalar retrospektif incelendi. Bulgular: Çalışmaya 162 (%62.8)’ si erkek, 96 (%37.2)’ sı kadın olmak üzere toplam 258 hasta alındı. Hastaların yaş ortalaması 45,98±17,42 idi. Olgular kontrol, akut bronşit ve pnömoni olarak üç gruba ayrıldı. Pnömoni tanısı alan hasta sayısı 39 (%15,11) , akut bronşit 77 (%29,8) iken kontrol hasta sayısı 142 (%55,03) idi. Gruplar arasında WBC, ESH, CRP ve Vücut Kitle İndeksi arasında istatiskel farklılık vardı (p=0,000). Yaş (p=0,875) ve fibrinojen (p=0,13) düzeyinde fark bulunmadı. WBC, ESH ve CRP sağlıklı grup ile alt solunum yolu enfeksiyonunu ayırmada ve akut bronşit/pnömoni ayrımını yapmada anlamlı katkı sağladığı gösterilmiştir. Pa akciğer grafisi akut bronşit ve pnömoni ayrımında istatiksel olarak anlamlı katkı sağlamaktadır. p<0,05 Sonuç: Pnömoni ve akut bronşit teşhisinde ve ayrımında CRP, WBC, ESH birlikte değerlendirmenin katkı sağlayacağı sonucuna varıldı.
Keywords
Akut-faz reaktanları Bronşit C-reaktif protein; Eritrosit sedimentasyon hızı; Lökosit; Pnömoni
References
- Bülbül Y. Akut bronşit. In Özlü T, Metintaş M, Karadağ M, Kaya A, eds. Solunum Sistemi ve Hastalıkları Temel Başvuru Kitabı. İstanbul. İstanbul Tıp Kitabevi. 2010. p. 951-4.
- Özlü T. Pnömoniler. In Özlü T, Metintaş M, Karadağ M, Kaya A, eds. Solunum Sistemi ve Hastalıkları Temel Başvuru Kitabı. İstanbul. İstanbul Tıp Kitabevi, 2010. p. 813-7.
- Llor C. Acute bronchitis: aetiology and treatment. In Blasi F, Miravitlles M, eds. The Spectrum Of Bronchial Infection, European Respiratory Monograph number 60. Norwich. Page Bros Ltd. 2013. p.1-17.
- Bircan A, Kaya Ö, Münire G, Öztürk Ö, Şahin Ü, Akkaya A. Toplum kökenli pnömonilerin ağırlığının değerlendirilmesinde C-reaktif protein, lökosit sayısı ve eritrosit sedimentasyon hızının yeri. Tüberküloz ve Toraks Dergisi 2006; 54(1): 22-9.
- Kolsuz M, Metintaş M, Uçgun İ. Toplum Kökenli Pnömonilerde Hastalık Şiddeti ile Akut Faz Reaktanları Arasındaki İlişki. Tüberküloz ve Toraks Dergisi. 2002; 50 (4): 431
- Tek M, Önde G, Uğurman F, Önde U, Şipit T, Samurkaşoğlu B. Toplumsal Kaynaklı pnömoni ve koah akut atağı olan hastalarda serum crp düzeylerinin karşılaştırılması. Solunum Hastalıkları 2000;11:28-34.
- Hopstaken RM, Muris JW, Knottnerus JA, Kester AD, Rinkens PE, Dinant GJ. Contributions of symptoms, signs, erythrocyte sedimentation rate, and C-reactive protein to a diagnosis of pneumonia in acute lower respiratory tract infection. Br J Gen Pract. 2003;53(490):358-64.
- Castro-Guardiola A, Armengou-Arxé A, Viejo-Rodríguez A, Peñarroja-Matutano G, Garcia-Bragado F. Differential diagnosis between community-acquired pneumonia and non-pneumonia diseases of the chest in the emergency ward. Eur J Intern Med. 2000;11(6):334-9.
- Melbye H, Straume B, Aasebİ U, Brox J. The diagnosis of adult pneumonia in general practice. The diagnostic value of history, physical examination and some blood tests. Scand J Prim Health Care. 1988;6(2):111-7.
- Holm A, Nexoe J, Bistrup LA, Pedersen SS, Obel N, Nielsen LP et al. Aetiology and prediction of pneumonia in lower respiratory tract infection in primary care. Br J Gen Pract. 2007;57(540):547-54.
- Farah R, Makhoul N. Usefulness of various inflammatory markers to differentiate pulmonary edema from pneumonia. Isr Med Assoc J. 2011;13(4):225-9.
- Melbye H, Straume B, Aasebİ U, Dale K. Diagnosis of pneumonia in adults in general practice. Relative importance of typical symptoms and abnormal chest signs evaluated against a radiographic reference standard. Scand J Prim Health Care. 1992;10(3):226-33.
- Melbye H, Straume B, Brox J. Laboratory tests for pneumonia in general practice: the diagnostic values depend on the duration of illness. Scand J Prim Health Care. 1992;10(3):234-40.
- Seppä Y, Bloigu A, Honkanen PO, Miettinen L, Syrjälä H. Severity assessment of lower respiratory tract infection in elderly patients in primary care. Arch Intern Med. 2001;161(22):2709-13.
- García Vázquez E, Martínez JA, Mensa J, Sánchez F, Marcos MA, de Roux A et al. C-reactive protein levels in community-acquired pneumonia. Eur Respir J. 2003;21(4):702-5.
- Hopstaken RM, Cals JW, Dinant GJ. Accuracy of lipopolysaccharide-binding protein (LBP) and fibrinogen compared to C-reactive protein (CRP) in differentiating pneumonia from acute bronchitis in primary care. Prim Care Respir J. 2009;18(3):227-30.
- Tatar D, Senol G, Anar C, Tibet G. Markers of lower respiratory tract infections in emergency departments. Multidiscip Respir Med. 2013;8(1):20.
- Vilar J, Domingo ML, Soto C, Cogollos J. Radiology of bacterial pneumonia. Eur J Radiol. 2004;51(2):102-13.
- Graffelman AW, Willemssen FE, Zonderland HM, Neven AK, Kroes AC, van den Broek PJ. Limited value of chest radiography in predicting aetiology of lower respiratory tract infection in general practice. Br J Gen Pract. 2008;58(547):93-7.
- El Solh AA, Aquilina AT, Gunen H, Ramadan F. Radiographic resolution of community-acquired bacterial pneumonia in the elderly. J Am Geriatr Soc. 2004;52(2):224
- Macfarlane J, Holmes W, Gard P, Macfarlane R, Rose D, Weston V et al. Prospective study of the incidence, aetiology and outcome of adult lower respiratory tract illness in the community. Thorax. 2001;56(2):109-14.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research |
| Authors | |
| Publication Date | February 27, 2015 |
| Published in Issue | Year 2015 Volume: 5 Issue: 1 |
