Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital
Abstract Background Procalcitonin (PCT) is a useful marker for pneumonia. However, its clinical usefulness in elderly patients has not been studied extensively. This study aimed to assess the relationship between PCT and prognosis and pneumonia severity in elderly patients with pneumonia acquired ou...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-01-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12877-018-1008-8 |
| _version_ | 1818309967693742080 |
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| author | Takanori Akagi Nobuhiko Nagata Hiroyuki Miyazaki Taishi Harada Satoshi Takeda Yuji Yoshida Kenji Wada Masaki Fujita Kentaro Watanabe |
| author_facet | Takanori Akagi Nobuhiko Nagata Hiroyuki Miyazaki Taishi Harada Satoshi Takeda Yuji Yoshida Kenji Wada Masaki Fujita Kentaro Watanabe |
| author_sort | Takanori Akagi |
| collection | DOAJ |
| description | Abstract Background Procalcitonin (PCT) is a useful marker for pneumonia. However, its clinical usefulness in elderly patients has not been studied extensively. This study aimed to assess the relationship between PCT and prognosis and pneumonia severity in elderly patients with pneumonia acquired outside the hospital. Methods Data considered relevant to pneumonia severity and prognosis were retrospectively obtained from clinical charts of all patients with pneumonia who were admitted to our hospital from 2010 to 2017. The primary outcome was 30-day mortality in elderly patients (aged ≥75 years), and the relationship between PCT levels and pneumonia severity, as determined by the pneumonia severity index (PSI) was also examined. Results Data were collected from 667 patients, of which 436 were elderly patients. Multivariate and receiver operating characteristic curve analysis revealed that albumin, body mass index, and PSI class rather than PCT are important factors related to 30-day mortality in elderly patients. PCT was also not an independent prognostic factor in younger patients. PCT levels significantly differed by pneumonia severity (mild, moderate, and severe) in both younger (p < 0.001) and elderly (p < 0.0001) patients, with levels increasing as severity increased. In contrast, C-reactive protein (CRP) levels and white blood cell counts did not significantly differ by pneumonia severity in younger and elderly patients. A subgroup analysis focused on Streptococcus pneumoniae pneumonia revealed that PCT levels differed by severity in elderly patients (p = 0.03), with levels increasing as severity increased. Conclusion PCT was not an independent predictor of 30-day mortality in both of elderly and younger patients. PCT levels, but not CRP levels, significantly increased with increasing pneumonia severity in younger and elderly patients, although the degree of increase tended to be lower in elderly patients compared to younger patients for the same severity. PCT levels also significantly increased with increasing pneumonia severity in elderly patients with Streptococcus pneumoniae pneumonia. |
| first_indexed | 2024-12-13T07:38:35Z |
| format | Article |
| id | doaj.art-7b3bbc713f6a477b844991b9586604b6 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-13T07:38:35Z |
| publishDate | 2019-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-7b3bbc713f6a477b844991b9586604b62022-12-21T23:55:01ZengBMCBMC Geriatrics1471-23182019-01-0119111010.1186/s12877-018-1008-8Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospitalTakanori Akagi0Nobuhiko Nagata1Hiroyuki Miyazaki2Taishi Harada3Satoshi Takeda4Yuji Yoshida5Kenji Wada6Masaki Fujita7Kentaro Watanabe8Department of Respiratory Medicine, Fukuoka University Chikushi HospitalDepartment of Respiratory Medicine, Fukuoka University Chikushi HospitalDepartment of Respiratory Medicine, Fukuoka University Chikushi HospitalDepartment of Respiratory Medicine, Fukuoka University Chikushi HospitalDepartment of Respiratory Medicine, Fukuoka University Chikushi HospitalDepartment of Respiratory Medicine, Fukuoka University Chikushi HospitalDepartment of Respiratory Medicine, Fukuoka University Chikushi HospitalDepartment of Respiratory Medicine, Faculty of Medicine, Fukuoka UniversityDepartment of Respiratory Medicine, Faculty of Medicine, Fukuoka UniversityAbstract Background Procalcitonin (PCT) is a useful marker for pneumonia. However, its clinical usefulness in elderly patients has not been studied extensively. This study aimed to assess the relationship between PCT and prognosis and pneumonia severity in elderly patients with pneumonia acquired outside the hospital. Methods Data considered relevant to pneumonia severity and prognosis were retrospectively obtained from clinical charts of all patients with pneumonia who were admitted to our hospital from 2010 to 2017. The primary outcome was 30-day mortality in elderly patients (aged ≥75 years), and the relationship between PCT levels and pneumonia severity, as determined by the pneumonia severity index (PSI) was also examined. Results Data were collected from 667 patients, of which 436 were elderly patients. Multivariate and receiver operating characteristic curve analysis revealed that albumin, body mass index, and PSI class rather than PCT are important factors related to 30-day mortality in elderly patients. PCT was also not an independent prognostic factor in younger patients. PCT levels significantly differed by pneumonia severity (mild, moderate, and severe) in both younger (p < 0.001) and elderly (p < 0.0001) patients, with levels increasing as severity increased. In contrast, C-reactive protein (CRP) levels and white blood cell counts did not significantly differ by pneumonia severity in younger and elderly patients. A subgroup analysis focused on Streptococcus pneumoniae pneumonia revealed that PCT levels differed by severity in elderly patients (p = 0.03), with levels increasing as severity increased. Conclusion PCT was not an independent predictor of 30-day mortality in both of elderly and younger patients. PCT levels, but not CRP levels, significantly increased with increasing pneumonia severity in younger and elderly patients, although the degree of increase tended to be lower in elderly patients compared to younger patients for the same severity. PCT levels also significantly increased with increasing pneumonia severity in elderly patients with Streptococcus pneumoniae pneumonia.http://link.springer.com/article/10.1186/s12877-018-1008-8ProcalcitoninC-reactive proteinPneumoniaPneumonia severityPrognosisElderly |
| spellingShingle | Takanori Akagi Nobuhiko Nagata Hiroyuki Miyazaki Taishi Harada Satoshi Takeda Yuji Yoshida Kenji Wada Masaki Fujita Kentaro Watanabe Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital BMC Geriatrics Procalcitonin C-reactive protein Pneumonia Pneumonia severity Prognosis Elderly |
| title | Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital |
| title_full | Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital |
| title_fullStr | Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital |
| title_full_unstemmed | Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital |
| title_short | Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital |
| title_sort | procalcitonin is not an independent predictor of 30 day mortality albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital |
| topic | Procalcitonin C-reactive protein Pneumonia Pneumonia severity Prognosis Elderly |
| url | http://link.springer.com/article/10.1186/s12877-018-1008-8 |
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