{rfName}
In

Indexed in

License and use

Citations

468

Altmetrics

Grant support

This work was funded by the Institute de Salud Carlos III (ES) - European Regional Development Fund - PI 12/01142 and PI 15/01231; and Spanish Respiratory Society - SEPAR 2013.

Analysis of institutional authors

Maria Galvan-Roman, JoseAuthorRajas, OlgaAuthorDe La Fuente, HortensiaAuthorSuarez, CarmenAuthorAncochea, JulioAuthor
Share
Publications
>
Article

Inflammation biomarkers in blood as mortality predictors in community-acquired pneumonia admitted patients: Importance of comparison with neutrophil count percentage or neutrophil-lymphocyte ratio

Publicated to:PLoS ONE. 12 (3): 0173947- - 2017-03-16 12(3), DOI: 10.1371/journal.pone.0173947

Authors: Curbelo, Jose; Luquero Bueno, Sergio; Maria Galvan-Roman, Jose; Ortega-Gomez, Mara; Rajas, Olga; Fernandez-Jimenez, Guillermo; Vega-Piris, Lorena; Rodriguez-Salvanes, Francisco; Arnalich, Belen; Diaz, Ana; Costa, Ramon; de la Fuente, Hortensia; Lancho, Angel; Suarez, Carmen; Ancochea, Julio; Aspa, Javier

Affiliations

Hosp Henares, Dept Pneumol, Madrid, Spain       - Author
Hosp Univ La Princesa, Inst Invest Sanitaria, Biobank, Madrid, Spain       - Author
Hosp Univ La Princesa, Inst Invest Sanitaria, Clin Informat Unit, Madrid, Spain       - Author
Hosp Univ La Princesa, Inst Invest Sanitaria, Dept Clin Anal, Madrid, Spain - Author
Hosp Univ La Princesa, Inst Invest Sanitaria, Dept Immunol, Madrid, Spain       - Author
Hosp Univ La Princesa, Inst Invest Sanitaria, Dept Internal Med, Madrid, Spain       - Author
Hosp Univ La Princesa, Inst Invest Sanitaria, Dept Pneumol, Madrid, Spain       - Author
Hosp Univ La Princesa, Inst Invest Sanitaria, Methodol Unit, Madrid, Spain       - Author
       - Author
      Hosp Univ La Princesa, Inst Invest Sanitaria, Dept Pneumol, Madrid, Spain. - Author
See more

Abstract

The increase and persistence of inflammation in community-acquired pneumonia (CAP) patients can lead to higher mortality. Biomarkers capable of measuring this inadequate inflammatory response are likely candidates to be related with a bad outcome. We investigated the association between concentrations of several inflammatory markers and mortality of CAP patients.This was a prospective study of hospitalised CAP patients in a Spanish university hospital. Blood tests upon admittance and in the early-stage evolution (72-120 hours) were carried out, where C-reactive protein, procalcitonin, proadrenomedullin, copeptin, white blood cell, Lymphocyte Count Percentage (LCP), Neutrophil Count Percentage (NCP) and Neutrophil/Lymphocyte Ratio (NLR) were measured. The outcome variable was mortality at 30 and 90 days. Statistical analysis included logistic regression, ROC analysis and area-under-curve test.154 hospitalised CAP patients were included. Patients who died during follow-up had higher levels of procalcitonin, copeptin, proadrenomedullin, lower levels of LCP, and higher of NCP and NLR. Remarkably, multivariate analysis showed a relationship between NCP and mortality, regardless of age, severity of CAP and comorbidities. AUC analysis showed that NLR and NCP at admittance and during early-stage evolution achieved a good diagnostic power. ROC test for NCP and NLR were similar to those of the novel serum biomarkers analysed.NLR and NCP, are promising candidate predictors of mortality for hospitalised CAP patients, and both are cheaper, easier to perform, and at least as reliable as the new serum biomarkers. Future implementation of new biomarkers would require comparison not only with classic inflammatory parameters like White Blood Cell count but also with NLR and NCP.

Keywords
AgedAged, 80 and overAssociationBiomarkersCommunity-acquired infectionsFemaleHospitalizationHumansInflammationLong-term mortalityLymphocytesMaleMetaanalysisNeutrophilsOutcomesPatient admissionPneumoniaPro-adrenomedullinProadrenomedullinProspective studiesResectionSeveritySurvival

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal PLoS ONE due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2017, it was in position 15/64, thus managing to position itself as a Q1 (Primer Cuartil), in the category Multidisciplinary Sciences.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 3.44. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Weighted Average of Normalized Impact by the Scopus agency: 6.71 (source consulted: FECYT Feb 2024)
  • Field Citation Ratio (FCR) from Dimensions: 32.26 (source consulted: Dimensions Apr 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-04-28, the following number of citations:

  • WoS: 105
  • Scopus: 104
  • Europe PMC: 65
  • Google Scholar: 194
  • OpenCitations: 104
Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-04-28:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 157.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 157 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 6.5.
  • The number of mentions on the social network X (formerly Twitter): 5 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.