SESSION TYPE: Biomarkers in Respiratory Infections
PRESENTED ON: Monday, October 22, 2012 at 11:15 AM - 12:30 PM
PURPOSE: Community-acquired pneumonia (CAP) is one of the leading cause of death in elderly. Recently, several studies have reported the clinical usefulness of measurement of plasma procalcitonin (PCT), a biomarker of bacterial infection in patients. But the study whether plasma PCT is also useful to predict severity in elderly with CAP has not been reported yet. The aim of this study was to evaluate usefulness of PCT as a tool to predict severity of CAP in elderly and whether existing cut-off value of PCT reflects the mortality in elderly patients with CAP.
METHODS: This study covered 155 CAP cases that was admitted to Pusan National University Hospital between January, 2010 and December, 2010. Patients were divided in two groups by the age of 65 years (elderly patients, 99; young patients, 56). All enrolled subjects were measured for PCT, C-reactive protein (CRP), white blood cell (WBC), Confusion, Uremia, Respiratory rate, Blood pressure, 65 years of age or older (CURB-65) and Pneumonia Severity of Index (PSI). Spearman correlation analysis was performed to evaluate the relation of biomarkers and CAP severity.
RESULTS: Plasma PCT level was significantly correlated with the CURB-65, PSI in total patients with CAP. Especially more strong correlation was observed between the PCT and CURB-65 in elderly. (PCT and CURB-65, ρ=0.408 with p=0.000; PCT and PSI, ρ=0.293 with p=0.003; PCT and mortality, ρ=0.229 with p=0.023). The correlation between CRP or WBC and CAP severity was low. The existing cut-off value of PCT was partially associated with mortality in all patients but it didn't show the better association between PCT and mortality in elderly.
CONCLUSIONS: Plasma PCT level is a more useful marker than CRP or WBC for predict the severity of CAP but doesn't reflect the association between PCT and mortality in elderly patients.
CLINICAL IMPLICATIONS: Plasma PCT level is a more useful marker than CRP or WBC for predict the severity of CAP.
DISCLOSURE: The following authors have nothing to disclose: Kiuk Kim, Jeong Ha Mok, Doo Soo Jeon, Yun Seong Kim, Kwangha Lee, Hyeon Gook Lee, Min Ki Lee
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