Hubungan antara kadar procalcitonin dengan kriteria Anthonisen pada PPOK eksaserbasi akut

Abstract

Background: COPD exacerbations can be caused by infections and environmental pollutants. One guideline for antibiotic administration in acute exacerbation COPD is in patients with Anthonisen criteria types 1 and 2 based on patients' subjective complaints (increased dyspneu, increased sputum volume and sputum purulence). Procalcitonin (PCT) is an objective and specific marker of bacterial infections that are not affected much by disease condition or steroid drugs that are widely used by COPD patients. This study was conducted to determine the relationship between procalcitonin levels and Anthonisen criteria in acute exacerbation of COPD.
 Methods: This study used an analytical cross sectional design at Sanglah General Hospital and Wangaya Hospital in March-May 2018. Data analysis used the Bivariate Spearman correlation test, and Kruskal-wallis to determine the median PCT level difference according to Anthonisen type.
 Result: Total subjects were 43 samples of acute exacerbation COPD patients, with median PCT levels were 0.18 (0.02-47.8) ng/ml. Spearman correlation analysis showed no significant correlation between serum PCT levels and Anthonisen type (r = -0,175, p = 0.26). We also found a significant correlation between Anthonisen criteria with WBC and neutrophil count. After excluding several outliers data, there was a significant difference in median PCT value based on the Anthonisen type. The median PCT was higher in Anthonisen type 1 compared to type 2 and 3 (p = 0.029). 
 Conclusion: there was no relationship between levels of PCT with Anthonisen type but we found significant higher PCT level in Anthonisen type 1 after excluding extreme value.