New possibilities for assessing the severity of community-acquired pneumonia among military personnel

Abstract

The results of a retrospective and prospective study of 673 case histories of young servicemen who were treated in military medical organizations of the Ministry of Defense of the Russian Federation regarding community-acquired pneumonia are presented. It has been established that in young soldiers, severe community-acquired pneumonia is characterized by a transient decrease in the level of free threeiodineyronin in the absence of structural changes in the thyroid gland. Reduction of free threeiodineyronin in the serum of less than 2,62 pg/ml is a marker of severe course and poor prognosis of the course of the disease and correlates with hypotension, impaired consciousness, increase in the number of points on the scales assessing the severity of pneumonia and hospital stay. Functional disorders of the thyroid gland are a reflection of the unfavourable endocrine-metabolic situation in the body, combined with a more severe course of pneumonia, and these changes in young soldiers suffering from community- acquired pneumonia are more pronounced. It was revealed that the scale «Systolic blood pressure, multilobar chest radiography involvement, respiratory rate, tachycardia, confusion, blood oxygenation» has the highest sensitivity, specificity and accuracy in assessing the severity of community-acquired pneumonia in young soldiers, and the use of such additional criteria as the level of free threeiodineyronin less than 2,62 pg/ml allows you to improve the information content of this scale to identify patients suffering from severe community-acquired pneumonia, in need of respiratory and inotropic support in the intensive care unit.

Keywords

community-acquired pneumonia / scales of severity assessment / an additional criterion of severity / young soldiers / a marker of severe course / functional disorders of the thyroid gland / the level of free threeiodineyronin

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RIGHTS & PERMISSIONS

Rubtsov Yu.E., Khalimov Yu.Sh., Gayduk S.V., Gayvoronskiy I.N.