Usefulness of a semi‐quantitative procalcitonin test and the A‐DROP Japanese prognostic scale for predicting mortality among adults hospitalized with community‐acquired pneumonia

Kasamatsu, Yu; Yamaguchi, Toshimasa; Kawaguchi, Takashi; Tanaka, Nagaaki; Oka, Hiroko; Nakamura, Tomoyuki; Yamagami, Keiko; Yoshioka, Katsunobu; Imanishi, Masahito

doi:10.1111/j.1440-1843.2011.02101.x

Cited by 24 publications

(34 citation statements)

References 28 publications

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“…In contrast to the results of the present study, Kasamatsu et al 9 showed that the semi-quantitative procalcitonin measurement was useful for predicting mortality from CAP. We can propose 2 possible explanations for this discrepancy.…”

Section: Discussioncontrasting

confidence: 54%

“…However, there are few data on the usefulness of the semi-quantitative serum procalcitonin test for predicting clinical outcomes of patients with CAP. To our knowledge, only one report, by Kasamatsu et al, 9 showed that the semi-quantitative procalcitonin test was useful for predicting mortality from CAP, but it was not as useful as the Pneumonia Severity Index, CURB-65 scale, and A-DROP scale. In short, the significance of performing this semiquantitative serum procalcitonin test on patients with CAP has not yet been adequately revealed.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussioncontrasting

confidence: 54%

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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“…Kasamatsu et al, have studied the predictive ability of baseline serum PCT for mortality using the semiquantitative kits and compared it to the A DROP, CURB-65 and PSI scores. They found that baseline serum PCT levels were positively correlated with the PSI and the CURB-65 [25]. They concluded that the baseline serum PCT level is useful for predicting 30 day mortality in adult patients with CAP which is similar to our findings.…”

Section: Discussionsupporting

confidence: 81%

“…The sensitivity and specificity of procalcitonin of ≥ 2ng/ml to predict 30 day mortality was 100% and 73.47% respectively, the negative predictive value was 100 and the area under receiver operating characteristics curve was 0.92 (0.85 -1.0). Kasamatsu Yu et al, in his study using similar semi-quantitative test with a cut off of ≥ 0.5ng/ml reported AUC for predicting 30 day mortality with PCT as 0.80 (0.70 -0.90) [25]. A study by Kim et al, showed that the odds ratio for severe pneumonia showed a seven to eight fold increase for PSI and CURB-65 at PCT level of ≥ 2.0 ng/ ml and the odds ratio for mortality had seven fold increase with PCT > 10ng/ml [26].…”

Section: Discussionmentioning

confidence: 99%

Role of Semi-quantitative Serum Procalcitonin in Assessing Prognosis of Community Acquired Bacterial Pneumonia Compared to PORT PSI, CURB-65 and CRB-65

Fernandes

Arora

Mesquita

2015

JCDR

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“…Several studies demonstrate an association between elevated PCT and mortality in septic patients [17, 18]. Although the addition of initial PCT to clinical indices improves prognostic performance of severity scores [19, 20], a large European study failed to validate these findings [21].…”

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confidence: 99%

Serial Procalcitonin as a Predictor of Bacteremia and Need for Intensive Care Unit Care in Adults With Pneumonia, Including Those With Highest Severity: A Prospective Cohort Study

McCluskey

Schuetz

Bearnot³

et al. 2017

Open Forum Infectious Diseases

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Background.Procalcitonin (PCT) is a prohormone that rises in bacterial pneumonia and has promise in reducing antibiotic use. Despite these attributes, there are inconclusive data on its use for clinical prognostication. We hypothesize that serial PCT measurements can predict mortality, intensive care unit (ICU) admission, and bacteremia.Methods.A prospective cohort study of inpatients diagnosed with pneumonia was performed at a large tertiary care center in Boston, Massachusetts. Procalcitonin was measured on days 1 through 4. The primary endpoint was a composite adverse outcome defined as all-cause mortality, ICU admission, and bacteremia. Regression models were calculated with area under the receiver operating characteristic curve (AUC) as a measure of discrimination.Results.Of 505 patients, 317 patients had a final diagnosis of community-acquired pneumonia (CAP) or healthcare-associated pneumonia (HCAP). Procalcitonin was significantly higher for CAP and HCAP patients meeting the composite primary endpoint, bacteremia, and ICU admission, but not mortality. Incorporation of serial PCT levels into a statistical model including the Pneumonia Severity Index (PSI) improved the prognostic performance of the PSI with respect to the primary composite endpoint (AUC from 0.61 to 0.66), bacteremia (AUC from 0.67 to 0.85), and need for ICU-level care (AUC from 0.58 to 0.64). For patients in the highest risk class PSI >130, PCT was capable of further risk stratification for prediction of adverse outcomes.Conclusion.Serial PCT measurement in patients with pneumonia shows promise for predicting adverse clinical outcomes, including in those at highest mortality risk.

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Usefulness of a semi‐quantitative procalcitonin test and the A‐DROP Japanese prognostic scale for predicting mortality among adults hospitalized with community‐acquired pneumonia

Abstract: The semi-quantitative PCT test and the A-DROP scale were found to be useful for predicting mortality in adult patients with CAP.

Cited by 24 publications

References 28 publications

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

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

Role of Semi-quantitative Serum Procalcitonin in Assessing Prognosis of Community Acquired Bacterial Pneumonia Compared to PORT PSI, CURB-65 and CRB-65

Serial Procalcitonin as a Predictor of Bacteremia and Need for Intensive Care Unit Care in Adults With Pneumonia, Including Those With Highest Severity: A Prospective Cohort Study

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