Document Detail


Diagnostic and prognostic values of admission procalcitonin levels in community-acquired pneumonia in an intensive care unit.
MedLine Citation:
PMID:  16091896     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Measurement of procalcitonin (PCT) has been studied for several years in infectious diseases. Some studies have focused on community-acquired pneumonia (CAP) but only one was conducted in critically ill patients hospitalized in an intensive care unit (ICU). PATIENTS AND METHODS: To determine the diagnostic and prognostic role of PCT in patients admitted in an intensive care unit for severe CAP, 110 patients hospitalized in our unit were prospectively studied. Within 48 hours following ICU admission, PCT serum level was measured with a quantitative method above a threshold value of 0.5 ng/ml. RESULTS: Initially focusing on the diagnostic value of PCT, 20% of the patients had a serum PCT level <0.5 ng/ml, 30% between 0.5 ng/ml and 2 ng/ml, and 50%>/=2 ng/ml. Serum PCT level was higher in microbiologically documented CAP (median=4.9 ng/ml vs 1.5 ng/ml if no bacteria were found; p=0.001), but was not predictive of any specific bacterial agent. Concerning the prognostic value, the serum PCT level was higher for bacteremic patients and/or septic shock patients (4.9 ng/ml vs 1.5 ng/ml; p=0.0003). Moreover, PCT levels were increased in patients who developed, during their ICU stay, infection-related complications (septic shock, multiorgan dysfunction, acute respiratory distress syndrome and disseminated intravascular coagulation). Finally, the initial PCT level was significantly higher in patients who died during the ICU stay (5.6 ng/ml vs 1.5 ng/ml; p<0.0001). Such a relationship was not found with C-reactive protein (CRP). CONCLUSION: In ICU patients admitted for severe CAP, initial PCT values could be an interesting predictor for complications and mortality.
Authors:
N Boussekey; O Leroy; H Georges; P Devos; T d'Escrivan; B Guery
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Infection     Volume:  33     ISSN:  0300-8126     ISO Abbreviation:  Infection     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-10     Completed Date:  2005-09-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0365307     Medline TA:  Infection     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  257-63     Citation Subset:  IM    
Affiliation:
Intensive Care and Infectious Disease Unit, Tourcoing Hospital, 135, rue du Président Coty - BP 619, 59208 Tourcoing cedex, France. nboussekey@caramail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bacteremia / diagnosis,  etiology
Calcitonin / blood*
Community-Acquired Infections
Critical Illness
Diagnosis, Differential
Female
Humans
Intensive Care Units*
Male
Middle Aged
Pneumonia / diagnosis*,  etiology
Predictive Value of Tests
Prognosis
Prospective Studies
Protein Precursors / blood*
Sensitivity and Specificity
Shock, Septic / diagnosis,  etiology
Chemical
Reg. No./Substance:
0/Protein Precursors; 56645-65-9/procalcitonin; 9007-12-9/Calcitonin

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