Utility of procalcitonin in predicting mortality among cases of hospital-acquired pneumonia: a North Indian study

Kumar, Sandeep; Jan, Rafi A; Rasool, Roohi; Fomda, Bashir Ahmad; Koul, Parvaiz A; Shah, Sonaullah; Umar, Hayatu; Qadri, S. M. Hussain; Masoodi, Shariq Rashid; Muzamil, Mudasir

doi:10.4103/ejcdt.ejcdt_21_18

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“…PCT has been used to differentiate between infectious and noninfectious inflammatory respiratory diseases, or bacterial and non-bacterial respiratory infectious diseases [2–4]. Many investigators have reported the clinical usefulness of PCT in patients with CAP [5–7, 17–26], HCAP [37, 38], ventilator-associated pneumonia (VAP) [39–43], and hospital-acquired pneumonia (HAP) [44]. Although these studies included many elderly patients, the clinical usefulness of PCT in those patients was not consistent.…”

Section: Discussionmentioning

confidence: 99%

“…Though many investigators have studied the utility of PCT in predicting mortality in various types of pneumonia including CAP [5–7, 17–26], HCAP [37, 38], VAP [39–43] and HAP [44], their results were not consistent While some reported PCT to be a reliable predictor for mortality [17–26], others showed that PCT was inferior to other markers such as PSI, CURB-65 [52], CRP, IL-6 [53], or BUN/albumin ratio [54] for predicting mortality. Several investigators reported that serial measurements of PCT were useful for predicting mortality [21, 50, 55].…”

Section: Discussionmentioning

confidence: 99%

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Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital

et al. 2019

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BackgroundProcalcitonin (PCT) is a useful marker for pneumonia. However, its clinical usefulness in elderly patients has not been studied extensively. This study aimed to assess the relationship between PCT and prognosis and pneumonia severity in elderly patients with pneumonia acquired outside the hospital.MethodsData considered relevant to pneumonia severity and prognosis were retrospectively obtained from clinical charts of all patients with pneumonia who were admitted to our hospital from 2010 to 2017. The primary outcome was 30-day mortality in elderly patients (aged ≥75 years), and the relationship between PCT levels and pneumonia severity, as determined by the pneumonia severity index (PSI) was also examined.ResultsData were collected from 667 patients, of which 436 were elderly patients. Multivariate and receiver operating characteristic curve analysis revealed that albumin, body mass index, and PSI class rather than PCT are important factors related to 30-day mortality in elderly patients. PCT was also not an independent prognostic factor in younger patients. PCT levels significantly differed by pneumonia severity (mild, moderate, and severe) in both younger (p < 0.001) and elderly (p < 0.0001) patients, with levels increasing as severity increased. In contrast, C-reactive protein (CRP) levels and white blood cell counts did not significantly differ by pneumonia severity in younger and elderly patients. A subgroup analysis focused on Streptococcus pneumoniae pneumonia revealed that PCT levels differed by severity in elderly patients (p = 0.03), with levels increasing as severity increased.ConclusionPCT was not an independent predictor of 30-day mortality in both of elderly and younger patients. PCT levels, but not CRP levels, significantly increased with increasing pneumonia severity in younger and elderly patients, although the degree of increase tended to be lower in elderly patients compared to younger patients for the same severity. PCT levels also significantly increased with increasing pneumonia severity in elderly patients with Streptococcus pneumoniae pneumonia.

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