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Journal of The Korean Society of Emergency Medicine 2014;25(3): 299-306. |
| Usefulness of Procalcitonin Levels in Assessing Severity in Patients with Healthcare-associated Pneumonia |
| Jong Ho Park, Jong Won Kim, Sang Min Park, Kyeong Ryong Lee, Sang O Park, Kwang Je Baek, Dae Young Hong |
| Department of Emergency Medicine, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Korea. 20070123@kuh.ac.kr |
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| ABSTRACT |
PURPOSE:
Healthcare-associated pneumonia (HCAP) has been proposed as a new category of pneumonia. However, studies of HCAP patients in Korea are limited. The aim of this study was to investigate the usefulness of procalcitonin (PCT) in assessment of the severity of HCAP patients.
METHODS:
We conducted a retrospective study of patients with HCAP who were hospitalized between August 2009 and July 2013. We evaluated white blood cell, C-reactive protein, and PCT, along with the pneumonia severity index score and CURB-65 in HCAP patients.
RESULTS:
The mean age of the 78 patients was 77.5 years. The PSI and CURB-65 scores showed similar trends of increasing mortality with worsening risk class in HCAP patients. The median PCT level was significantly higher in the non-survival group than in the survival group (3.1 ng/mL vs 0.4 ng/mL, p=0.003). The PCT level was significantly higher in patients with positive blood cultures (0.95 ng/mL vs 0.36 ng/mL, p=0.010). PCT levels rose consistently as PSI class advanced from class I/II/III to class V (p<0.001). In receiver operating characteristic curves analysis for prediction of mortality, PCT level had an area under the curve (AUC) of 0.655 (95% confidence interval 0.523-0.786).
CONCLUSION:
We found that measurement of PCT in the emergency department may provide helpful information for use in assessment of HCAP patients. |
| Key words:
Pneumonia, Severity of illness index, Procalcitonin |
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