Background: Community-acquired pneumonia (CAP) severity assessment is crucial to determine disease severity and provide better management to decrease 30-day mortality rate. Antithrombin III (AT-III) as a biomarker of coagulation may play a role in determining the diagnosis and prognosis of patients with CAP. Objective: To determine the association between the level of AT-III at hospital admission with 30-day mortality in patients with CAP.
Methods: This is a prospective cohort study. A total of 55 subjects who met CAP criteria in the emergency department of H. Adam Malik Hospital, Medan during February to May 2013 were examined using CURB-65 score. The level of ATIII was measured. Chi-square test was used to determine the association between AT-III level and 30-day mortality. Results: Among 55 subjects, all 9 subjects with low levels of AT-III had severe CAP based on CURB-65 score. Of 20 (36,4%) subjects who died, 8 (88,9%) subjects had low level of AT-III. There is a significant relationship between low levels of AT-III and 30-day mortality (p=0,0001).
Conclusion: Antithrombin-III levels at hospital admission in patients with CAP is associated with 30-day mortality. The lower AT-III level is, the higher 30-day mortality will be.
Keywords: Community-acquired pneumonia, CURB-65, antithrombin-III, 30-day mortality.