Free and Total Cortisol Levels as Predictors of Severity and Outcome in Community-acquired Pneumonia

• DOI: 10.1164/rccm.200702-307oc
• Publication Date: 2007-08-17T00:54:53Z
• Authors: Mirjam Christ-Crain; Daiana Stolz; Sukhdeep Jutla; Orestes Couppis; Christian Müller; Roland Bingisser; Philipp Schuetz; Michael Tamm; Ray Edwards; Beat Müller; Ashley B. Grossman
• Keywords: Procalcitonin; Pneumonia severity index; Univariate analysis

Rationale: High cortisol levels are of prognostic value in sepsis. The predictive pneumonia is unknown. Routinely available assays measure serum total (TC) and not free (FC). Whether FC concentrations better reflect outcome uncertain.Objectives: To investigate the TC community-acquired (CAP).Methods: Preplanned subanalysis a prospective intervention study 278 patients presenting to emergency department with CAP.Measurements Main Results: TC, FC, procalcitonin, C-reactive protein, leukocytes, clinical variables, severity index (PSI) were measured. major measures PSI survival. but protein or increased increasing CAP according (P < 0.001). on presentation who died during follow-up significantly higher as compared survivors. In receiver operating characteristic analysis predict survival, area under curve (AUC) was 0.76 (95% confidence interval, 0.70–0.81) for 0.69 (0.63–0.74) FC. This similar AUC (0.76 [0.70–0.81]), leukocytes. univariate analysis, only predictors death. multivariate potential equaled power points.Conclusions: Cortisol extent PSI, than routinely measured laboratory parameters. CAP, accuracy superior TC.Clinical trial registered www.controlled-trials.com (ISRCTN04176397).