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Medicina interna de México

Print version ISSN 0186-4866

Abstract

GARCIA-ARROYO, A. et al. Lactic dehydrogenase as a prognostic factor in pneumonias. Med. interna Méx. [online]. 2017, vol.33, n.5, pp.563-571. ISSN 0186-4866.  http://dx.doi.org/10.24245/mim.v33i5.1042.

BACKGROUND:

The 2009 influenza pandemic renewed interest in timely identification of suspected influenza cases through routine laboratory studies, the most studied is lactic dehydrogenase (DHL).

OBJECTIVE:

To determine if patients with influenza A (H1N1) pneumonia present particular alterations inside routine laboratory studies, particularly in DHL levels and analyze the prognostic implication.

MATERIAL AND METHOD:

A case-control study of patients with confirmed diagnosis of influenza A (H1N1) pneumonia (case), and patients with bacterial pneumonia (control) treated from December 2013 to July 2014.

RESULTS:

Thirty-one cases were analyzed, 45% (n = 14) had a diagnosis of influenza A (H1N1) pneumonia, the remaining 55% (n = 17) was considered of bacterial etiology. The mean age was 38 (16-62) years old. The DHL level at diagnosis time was on average 578.77 IU/L (191-1096), higher in the group with influenza A (H1N1) pneumonia (573 IU/L vs 624.7 IU/L, p = 0.366). In the overall analysis, the levels of DHL > 350 IU/L at diagnosis time and at the end of treatment had a negative impact on mortality (OR: 84.0, 95%CI: 4.4754-1576.6044, and OR: 154.0, 8.6261-2749.3255). Overall survival was 18 days, lower in the A (H1N1) group (4 vs 25 days, p = 0.016).

CONCLUSIONS:

DHL > 350 IU/L can be considered a severity biomarker, also has a negative impact on the survival of patients with pneumonia without being able to discriminate the possible etiological agent.

Keywords : L-lactate dehydrogenase; survival analysis; influenza A virus; H1N1 subtype; pneumonia; bacterial; pneumonia; prognosis.

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