International Journal of Multidisciplinary Health Sciences and Research

Category: Original Article,      DOI: Recived: 05/11/2023, Accepted: 23/12/2023, Published online: 29/12/2023

Evaluation of Serum Amyloid A as a Prognostic Marker in Community-Acquired Pneumonia

Dharmsheel Shrivastav

Abstract:

Background: Community-acquired pneumonia (CAP) remains a significant cause of morbidity and mortality worldwide. This study evaluated the prognostic value of Serum Amyloid A (SAA) in CAP patients and compared it with established biomarkers and severity scores. Methods: In this prospective, observational cohort study, we enrolled 200 adult patients admitted with CAP at a tertiary care hospital over 24 months. SAA, C-reactive protein (CRP), and procalcitonin (PCT) levels were measured on admission. The primary outcome was 30-day all-cause mortality. Receiver operating characteristic (ROC) analysis, logistic regression, and net reclassification improvement (NRI) were performed to assess SAA's prognostic value. Results: The 30-day mortality rate was 14% (28/200). SAA levels were significantly higher in nonsurvivors compared to survivors (median 389.7 vs 142.5 mg/L, p<0.001). ROC analysis showed SAA (AUC 0.86, 95% CI: 0.79-0.93) outperformed CRP (AUC 0.78) and PCT (AUC 0.81) in predicting mortality. An SAA level >275 mg/L independently predicted 30-day mortality (adjusted OR 3.85, 95% CI: 1.68-8.82, p=0.001) after adjusting for age, disease severity, and other biomarkers. Adding SAA to the Pneumonia Severity Index improved risk reclassification (NRI 0.21, p=0.001) and discrimination (IDI 0.056, p<0.001). Conclusions: SAA demonstrates superior prognostic accuracy for 30-day mortality in CAP compared to traditional biomarkers and provides additional value when combined with existing severity scores. These findings suggest SAA could be a valuable tool for risk stratification in CAP, potentially improving clinical decision-making and patient outcomes.