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- Title
Serum Procalcitonin: An Independent Predictor of Clinical Outcome in Health Care-Associated Pneumonia.
- Authors
Hong, Dae Young; Park, Sang O; Kim, Jong Won; Lee, Kyeong Ryong; Baek, Kwang Je; Na, Ji Ung; Choi, Pil Cho; Lee, Young Hwan
- Abstract
Background: Early prediction of the clinical outcomes for health care-associated pneumonia (HCAP) patients is challenging. Objectives: This is the first study to evaluate procalcitonin (PCT) as a predictor of outcomes in HCAP patients. Methods: We conducted an observational study based on data for HCAP patients prospectively collected between 2011 and 2014. Outcome variables were intensive care unit (ICU) admission and 30-day mortality. PCT was categorized into three groups: <0.5,0.5-2.0, and >2.0 ng/ml. We analysed multiple variables including age, sex, comorbidities, clinical findings, and PCT group to assess their association with outcomes. Results: Of 245 HCAP patients, 99 (40.4%) were admitted to an ICU and 44 (18.0%) died within 30 days. The median PCT level was significantly higher in the ICU admission (1.19 vs. 0.4 ng/ml; p < 0.001) and 30-day mortality (3.3 vs.0.4 ng/ml; p < 0.001 ) groups. In multivariateanalysis, high PCT (>2.0 ng/ml) was strongly associated with ICU admission [odds ratio 3.734, 95% confidence interval (CI) 1.753-7.951; p = 0.001] and 30-day mortality (hazard ratio 2.254, 95% CI 1.250-5.340; p = 0.035). In receiver operating characteristic analysis, PCT had a poor discrimination power regarding ICU admission [0.695 of thearea underthecurve (AUC)] and a fair discrimination power regarding 30-day mortality in HCAP patients (0.768 of the AUC). Conclusions: High PCT on admission was strongly associated with ICU admission and 30-day mortality in HCAP patients. However, application of PCT alone seems to be limited to predicting outcomes.
- Subjects
PNEUMONIA; PNEUMONIA-related mortality; CALCITONIN; CONFIDENCE intervals; CROSS infection; HOSPITAL care; HOSPITAL admission &; discharge; INTENSIVE care units; MULTIVARIATE analysis; SCIENTIFIC observation; PATIENTS; PROBABILITY theory; RECEIVER operating characteristic curves; DESCRIPTIVE statistics; ODDS ratio; PROGNOSIS
- Publication
Respiration, 2016, Vol 92, Issue 4, p241
- ISSN
0025-7931
- Publication type
Article
- DOI
10.1159/000449005