Serum soluble CD163 as a predictor of intensive care need and mortality in community-acquired pneumonia

Aims To evaluate the role of serum soluble CD163 (sCD163) in predicting intensive care unit (ICU) admission and mortality in patients with community-acquired pneumonia (CAP).Materials and methods This prospective study included 135 participants (60 non-ICU CAP, 45 ICU CAP, and 30 healthy controls). Clinical and laboratory data were collected at admission. Serum sCD163 levels were measured using ELISA. Receiver operating characteristic (ROC) analysis and multivariate logistic regression were performed.Results Patients requiring ICU care had significantly higher PSI, CURB-65, NLR, and sCD163 levels (all p < 0.05). sCD163 demonstrated strong predictive performance for ICU admission (AUC = 0.951, 95% CI 0.904–0.998), with a cutoff value of 4.94 ng/mL (sensitivity 96%, specificity 66%). In multivariate analysis, age and sCD163 levels were independently associated with in-hospital mortality (p < 0.05).Conclusion Serum sCD163 is associated with disease severity, ICU requirement, and mortality in CAP. It may provide complementary value to established clinical scores for early risk stratification.