PURPOSE: To explore the diagnostic and prognostic role of serum procalcitonin (PCT) in acute exacerbations of COPD (AECOPD).
METHODS: A total of 100 patients with AECOPD and 20 of apparently healthy individuals (control group) were studied. On presentation, serum PCT concentrations were measured, and quantitative sputum culture was performed for AECOPD. The patients were reevaluated when they had returned to their stable clinical state .Pathogenic bacterial microorganism (PBM) was only regarded as significant if they reached a growth ≥105 CFU/ml, indicating the presence of bacterial exacerbation of COPD. The patients were classified into two subgroups: group A included patients with bacterial AECOPD (n = 40), group B included patients with nonbacterial AECOPD (n = 60).
RESULTS: On presentation, The levels of PCT for patients of group A [1.59 ± 0.52 µg/L] were significantly higher than group B [0.08 ± 0.02 µg/L] and control group [0.06 ± 0.03 µg/L]. When they had returned to their stable state, the levels of PCT for patients of group A decreased to [0.07 ± 0.04 µg/L] , which was significantly lower than that in exacerbation [[1.59 ± 0.52 µg/L] ; But in patients of group B compared with exacerbation the levels of PCT did not changed [0.078 ± 0.03 µg/L] . In the stable state, there were no differences in the PCT measurement between the two subgroups as well as between patients and control. Furthermore; a significant correlation was recorded between PCT levels in group A at time of presentation and temperature(r=0.988, p<0.05), leucocytic count (r=0.897,p<0.05), and FEV1% of predicted (r=0.889 ,p<0.05).
CONCLUSIONS: Procalcitonin is a good marker for differentiation between bacterial and nonbacterial AECOPD.It is helpful also for prognosis.
CLINICAL IMPLICATIONS: In patients presented with AECOPD, the elevation of serum PCT is associated with bacterial infection. Moreover; PCT can be used as a prognostic factor.
DISCLOSURE: The following authors have nothing to disclose: Gamal Agmy, Yasser Gad, Shahban Helal
No Product/Research Disclosure Information