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Role of Serum Procalcitonin as a Prognostic Biomarker in Community Acquired Pneumonia FREE TO VIEW

Sudhir Agarwal, MD; Arvind Mishra, MBBS
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Institute of Medical Sciences, Varanasi, India

Chest. 2013;144(4_MeetingAbstracts):388A. doi:10.1378/chest.1704209
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SESSION TITLE: ICU Infections Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Despite several studies, role of initial Procalcitonin (PCT) levels as a predictor of prognosis in the course of Community Acquired Pneumonia (CAP) remains somewhat undefined. Purpose of the present study was to analyse relationship between initial PCT levels and existing predictive scores in terms of final outcome of the disease.

METHODS: Fifty patients who received the diagnosis of CAP throughout the period of study were enrolled and examined comprehensively.Blood samples were collected.Microbiological tests done.Initial quantitative PCT levels and CRP levels were obtained.PCT levels were measured by commercially available monoclonal immunoluminometric assay(limit of detection 0.1microg/L).Patients were classified according to Pneumonia Severity Index (PSI ) and CURB-65 scores.PCT levels were compared among stratified risk groups.

RESULTS: Pathogens were identified in 26 patients(52%) and 16 (32%) had streptococcal pneumonia. Four out of 50 pts(8%) died.Three patients(6%) developed complications (pleural effusion) and PCT levels were higher in pneumococcal pneumonia. Multivariate regression analysis was done.Area under curve(AUC) for predicting mortality for CRP was ( 0.65,95% CI),for PCT was (0.81,95%CI),for CURB-65 was (0.88,95%CI)and for PSI score was (0.94,95%CI).AUC was highest for PSI and lowest for CRP.PCT levels strongly correlated with PSI and CURB-65 scores.PCT levels were higher in PSI classes 3 -5 (p = 0.01) and complications(p=0.03).

CONCLUSIONS: Serum Procalcitonin can be used as an adjuvant to already existing scores. It is more useful in predicting the outcome of CAP in high risk patients. It's superior to CRP but still can not replace the PSI and CURB -65 scores.

CLINICAL IMPLICATIONS: Serum Procalcitonin may be used as a prognostic biomarker in Community Acquired Pneumonia

DISCLOSURE: The following authors have nothing to disclose: Sudhir Agarwal, Arvind Mishra

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