Can Serum Surfactant Protein D Levels Be Used as an Effective Factor Instead of Clinical Severity Scores of Pneumonia in Pediatric Emergency Departments?

Abstract

Aim: To investigate whether serum surfactant protein D (SP-D) level is an applicable indicator in differentiating bacterial and viral pneumonia and determining clinical severity in cases with community-acquired pneumonia (CAP). Materials and Methods: A total of 67 subjects were analyzed prospectively; of these, 32 were patients (aged 1 month-18 years) with a diagnosis of CAP and 35 were healthy control subjects. Results: The median age of the patients was 17.5 months (1.5-156 months). The serum SP-D levels of the patient group were significantly higher than those of the control group (p<0.001). Based on the pneumonia clinical severity index, serum SP-D levels in patients with mild (n=7), moderate (n=19), and severe (n=6) pneumonia were significantly higher than those in the control group (p<0.001, respectively). The serum SP-D levels in patients with severe pneumonia were much higher than in those with mild and moderate grades based the clinical severity index (p<0.001 and p<0.001, respectively). Although the serum SP-D levels in the bacterial pneumonia group were higher than those in the viral pneumonia group, the difference was not statistically significant. Conclusion: Although serum SP-D has limited efficacy in differentiating bacterial and viral pneumonia with respect to CAP in children, it can be used as an effective bioindicator for determining the clinical severity of the disease in emergency services.