Prognostic value of dynamic thiol/dissulfid balance, ischemia modified albumin and ferroxidase kevels at emergency service patients living in A nursing home with diagnosis of pneumonia

Introduction and Purpose: Pneumonia is a clinical syndrome in which there is a radiological infiltration with the sign of lower respiratory tract infection and a pathogen can be identified in the specimen taken from the respiratory tract. The causative agent of pneumonia should be anticipated and empirical treatment should be started as early as possible. Pneumonias are divided into two groups according to their causes: Community acquired (CAP) and Hospitals acquired (HAP) pneumonia. To be in hospital for two days or more in the last 90 days, stay in long-term nursing home for health care, receiving infusion treatment at home (including antibiotics), nurseling decubit ulsers at home, hemodialysis within the last 30 days and presence of medicine-resistant bacterial infection in family members is defined as Health Care Acquired Pneumonia (HCAP) when there is any of these conditions. In 1975, the proportion of the population aged over 65 years old was 4.6%, but in 2016 it increased to 8.3%. In according to population of elderly, the number of nursing home will be increasing in time. In our country Though it is not being full identified in our country, Nursing Home Acquired Pneumonia is also discussed here which is differentiated mikrobiologically and clinically from community acquired pneumonia (CAP). As well as in all infections, is a highly contoversial issue on oxidative stress pathogenesis in pneumonia. In recent years, that measure oxidative stress induced substrates. In this examination thiol/disulfide balance, ischemia modified albumin (IMA) and ferroxidase activity were measured by the panel which called as EREL panel. Materials and Methods: This study was conducted with the approval of ethical committee and patients in Ankara Yıldırım Beyazıt University Atatürk Training and Research Hospital Emergency Medical Clinic. We studied 107 patients including healthy volunteers who applied to our clinic between November 2017 and February 2018 and who had HCAP and CAP diagnoses. This study included volunteers over 65 years of age who were diagnosed with medical history, physical examination, and medical imaging. Vital parameters were measured at the time of application. In addition to complete blood count and extensive biochemical parameters which is routine examinations, we studied the EREL panel, developed by Erel and Neşelioğlu, containing native thiol (NT), disulfide (D), total thiol (TT), ischemia modified albumin (IMA), ferroxidase and indices of these parameters. Results: In this study, there was no statistically significant difference was found in gender and ferroxidase activity between the pneumonia types; but there was statistically significant difference in age, NT level, IMA level, CRB65 score, PSI score and staging and 28 days mortality. Congestive hearth failure, systolic blood pressure, pulse rate, hematocrite value, lactat value and PSI score and stage are effective on mortality of totally 72 patient. Considering only the nursing home acquired pneumonia group, the factors affecting the mortality are the cognestive hearth failure in the medical history, sistolic blood pressure and the pulse rate. Conclusion: EREL panel, which is the main research topic is a valuable parameter at early detection in terms of oxidative stress; however, according to the results, it was seen that there was no effect on mortality.