Usefulness of Procalcitonin as a Marker of Systemic Infection in Emergency Department Patients: A Prospective Study

Abstract

We prospectively evaluated serum procalcitonin concentrations in patients who presented to an emergency department (ED) with suspected infectious or inflammatory disease. Of 195 study patients, 68 had final diagnosis of systemic infection, and 24 of those 68 had elevated serum procalcitonin levels (>0.5 ng/mL). The procalcitonin level had a sensitivity of 0.35 and specificity of 0.99 for the diagnosis of systemic infection. In multivariate analysis, the procalcitonin level was the only independent variable associated with this diagnosis; in contrast, the C-reactive protein level was not. All patients with systemic infections who ultimately died had procalcitonin levels of >0.5 ng/mL at admission. Procalcitonin levels were significantly higher in patients who ultimately died of systemic infection than in patients who survived. The optimal procalcitonin threshold for the ED population may be lower than that proposed for critically ill patients. Determination of the procalcitonin level may be useful for screening and prognosis of more-severely ill ED patients.

Procalcitonin predicts patients at low risk of death from community-acquired pneumonia across all CRB-65 classes

“…The present study confirms the findings of previous studies that PCT is a good predictor of pneumonia severity [16,18,19,22]. Patients with a higher CRB-65 score had significantly higher PCT levels.…”

“…Its level increases rapidly in bacterial infections but remains low in viral diseases. High plasma concentrations of PCT are typically seen in sepsis, meningitis and pneumonia [12][13][14][15][16][17]. PCT also seems to be a prognostic factor in sepsis and pneumonia [18,19].…”

Measuring procalcitonin (PCT) levels: a pilot study in early diagnosis of patients affected by ureterocutaneostomy infection

“…The PCT was also studied in various urological disorders (PCT results dominant in predicting the severity of acute pyelonephritis [11] and studies reveals a correlation in predicting urinate positive cultures in patients with ureteral obstruction from stones).…”

“…For the WBC count limit was > 10K / ml, for the PCT > 0.1 ng / ml, for neutrophils > 70%. Data have been analyzed with the SPSS statistical software to analyze these data [11].…”

“…The PCT was also studied in various urological disorders. Compared with other biomarkers, PCT results dominant in predicting the severity of acute pyelonephritis [11] and studies reveals a correlation in predicting urinate positive cultures in patients with ureteral obstruction from calculations [12]. The overall goal of this study, has been instead, to determine whether a biomarker PCT is relevant and useful in daily practice to predict urinary tract infections in patients with UCS.…”