Diagnostic and Prognostic Value of Procalcitonin in Community-Acquired Pneumonia

Horie, Masafumi; Suzuki, Mitsuaki; Noguchi, Satoshi; Tanaka, Wakae; Yoshihara, H.; Kawakami, Masaki; Kichikawa, Yoshiko; Sakamoto, Yoshio; Ugajin, Motoi

doi:10.1097/maj.0b013e31821d33ef

Cited by 29 publications

(24 citation statements)

References 22 publications

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“…PCT has been shown to be not only a diagnostic biomarker for bacterial infections but also accepted as a prognostic predictor of short- and long-term mortality in lower respiratory tract infections [18,23]. High PCT levels were reported to be related to increased morbidity and mortality in many patient populations such as those with pneumonia and severe sepsis [23,24,25,26].…”

Section: Introductionmentioning

confidence: 99%

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Serum Procalcitonin as a Biomarker for the Prediction of Bacterial Exacerbation and Mortality in Severe COPD Exacerbations Requiring Mechanical Ventilation

Ergan

Şahin²,

Topeli

2016

Respiration

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Background: Procalcitonin (PCT) is being used as a marker of bacterial infections. Although there are several studies showing the diagnostic yield of PCT to differentiate bacterial involvement in chronic obstructive pulmonary disease exacerbations (COPDE), the prognostic yield of PCT in severe COPDE has been studied less. Objectives: The primary aim was to determine whether the level of serum PCT at admission in severe COPDE serves as a prognostic biomarker for hospital mortality. The secondary aim was to determine the role of PCT in identifying a bacterial exacerbation. Methods: A total of 63 COPDE patients (median age 71 years; male 58.7%) were retrospectively analyzed from our intensive care unit database. Results: The hospital mortality rate was 23.8%. Admission PCT levels were higher in patients who died during hospitalization (0.66 vs. 0.17 ng/ml; p = 0.014). This association between hospital mortality and serum PCT level remained significant in a multivariate analysis; for every 1 ng/ml increase in PCT level, hospital mortality increased 1.85 times (odds ratio; 95% confidence interval: 1.07-3.19; p = 0.026). The optimal admission PCT threshold was 0.25 ng/ml in order to discern patients who had bacterial exacerbation with a sensitivity of 63%, a specificity of 67%, and a negative predictive value of 80%. The negative predictive value increased to 89% when both the admission and follow-up PCT levels remained <0.25 ng/ml. Conclusion: This study shows that admission PCT levels have a prognostic importance in estimating hospital mortality among patients with severe COPDE. A PCT level <0.25 ng/ml at the time of admission and during follow-up is suggestive of the absence of a bacterial cause of COPDE.

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Section: Introductionmentioning

confidence: 99%

“…High PCT levels were reported to be related to increased morbidity and mortality in many patient populations such as those with pneumonia and severe sepsis [23,24,25,26]. …”

Section: Introductionmentioning

confidence: 99%

Serum Procalcitonin as a Biomarker for the Prediction of Bacterial Exacerbation and Mortality in Severe COPD Exacerbations Requiring Mechanical Ventilation

Ergan

Şahin²,

Topeli

2016

Respiration

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“…4,5 The quantitative serum procalcitonin level has been reported to be a useful predictive prognostic marker in CAP. [6][7][8] However, to measure quantitative procalcitonin levels, ϳ16 million yen are necessary as a capital investment before the test can be conducted in Japan. Therefore, the medical facilities with the capability to measure quantitative procalcitonin levels immediately after blood sampling are limited due to the cost of the analysis.…”

Section: Introductionmentioning

confidence: 99%

Predictive Values of Semi-Quantitative Procalcitonin Test and Common Biomarkers for the Clinical Outcomes of Community-Acquired Pneumonia

Ugajin¹,

Yamaki²,

Hirasawa³

et al. 2013

Respir Care

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BACKGROUND:The semi-quantitative serum procalcitonin test (Brahms PCT-Q) is available conveniently in clinical practice. However, there are few data on the relationship between results for this semi-quantitative procalcitonin test and clinical outcomes of community-acquired pneumonia (CAP). We investigated the usefulness of this procalcitonin test for predicting the clinical outcomes of CAP in comparison with severity scoring systems and the blood urea nitrogen/serum albumin (B/A) ratio, which has been reported to be a simple but reliable prognostic indicator in our prior CAP study. METHODS: This retrospective study included data from subjects who were hospitalized for CAP from August 2010 through October 2012 and who were administered the semiquantitative serum procalcitonin test on admission. The demographic characteristics; laboratory biomarkers; microbiological test results; Pneumonia Severity Index scores; confusion, urea nitrogen, breathing frequency, blood pressure, > 65 years of age (CURB-65) scale scores; and age, dehydration, respiratory failure, orientation disturbance, pressure (A-DROP) scale scores on hospital admission were retrieved from their medical charts. The outcomes were mortality within 28 days of hospital admission and the need for intensive care. RESULTS: Of the 213 subjects with CAP who were enrolled in the study, 20 died within 28 days of hospital admission, and 32 required intensive care. Mortality did not differ significantly among subjects with different semi-quantitative serum procalcitonin levels; however, subjects with serum procalcitonin levels > 10.0 ng/mL were more likely to require intensive care than those with lower levels (P < .001). The elevation of semi-quantitative serum procalcitonin levels was more frequently observed in subjects with proven etiology, especially pneumococcal pneumonia. Using the receiver operating characteristic curves for mortality, the area under the curve was 0.86 for Pneumonia Severity Index class, 0.81 for B/A ratio, 0.81 for A-DROP, 0.80 for CURB-65, and 0.57 for semi-quantitative procalcitonin test. CONCLU-SIONS: The semi-quantitative serum procalcitonin level on hospital admission was less predictive of mortality from CAP compared with the B/A ratio. However, the subjects with serum procalcitonin levels > 10.0 ng/mL were more likely to require intensive care than those with lower levels.

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“…При пневмококковой пневмонии уровень прокальцитони-на значимо выше, чем при ВП другой этиологии [17]. Бактериемическая пневмококковая пневмония у опи-санного в клиническом случае № 1 ребенка протекала с резким повышением концентрации СРБ и септическим повышением содержания прокальцитонина.…”

Section: маркеры бактериального воспаления в диагностике пневмонииunclassified

Pneumococcal Infection in Children: Everyday Practice

Намазова-баранова¹,

Куличенко²,

Малахова³

et al. 2012

Vopr. sovr. pediatr.

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ВВЕДЕНИЕ Несмотря на доступные эффективные превентив-ные и терапевтические мероприятия, внебольничная пневмония (ВП) до сих пор вносит значимый вклад в заболеваемость и частоту госпитализаций детей во всех развитых странах мира. В развивающихся странах ВП до сегодняшнего дня в значительной сте-пени обусловливает детскую смертность [1]. В тече-ние последнего года опубликовано несколько офици-альных руководств, имеющих целью оптимизировать диаг ностику и лечение ВП у детей [2,3]. Однако их анализ показывает, что многие рекомендуемые диаг-ностические и терапевтические подходы к ВП далеко не всегда основываются на высоком уровне дока-зательности. Повседневная клиническая практика в свою очередь демонстрирует, что диагностика и лече-ние ВП у детей нередко не соотносятся ни с какими существующими современными стандартами. В связи с этим целью настоящей публикации явилось обсуж-дение трудных и нерешенных вопросов диагностики и лечения ВП у детей младшего возраста на основе анализа реальных клинических ситуаций. В дискус-сии авторы старались обращаться преимущественно к результатам выполненных в последние годы иссле-дований, основанных на принципах доказательной медицины.

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Diagnostic and Prognostic Value of Procalcitonin in Community-Acquired Pneumonia

Cited by 29 publications

References 22 publications

Serum Procalcitonin as a Biomarker for the Prediction of Bacterial Exacerbation and Mortality in Severe COPD Exacerbations Requiring Mechanical Ventilation

Serum Procalcitonin as a Biomarker for the Prediction of Bacterial Exacerbation and Mortality in Severe COPD Exacerbations Requiring Mechanical Ventilation

Predictive Values of Semi-Quantitative Procalcitonin Test and Common Biomarkers for the Clinical Outcomes of Community-Acquired Pneumonia

Pneumococcal Infection in Children: Everyday Practice

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