Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital

• Published in: BMC geriatrics 2019-01, Vol.19 (1), p.3-3, Article 3
• Main Authors: Akagi, Takanori, Nagata, Nobuhiko, Miyazaki, Hiroyuki, Harada, Taishi, Takeda, Satoshi, Yoshida, Yuji, Wada, Kenji, Fujita, Masaki, Watanabe, Kentaro
• Format: Article
• Language: English
• Subjects: Age; Aged; Aged, 80 and over; Albumin; Antibiotics; Bacterial infections; Biomarkers; Biomarkers - blood; Blood; Body mass index; C-reactive protein; Community-acquired infections; Community-Acquired Infections - blood; Community-Acquired Infections - diagnosis; Community-Acquired Infections - mortality; Demographic aspects; Elderly; Elderly patients; Female; Geriatrics; Hemodialysis; Hospitalization - trends; Hospitals; Humans; Intensive care; Male; Medical prognosis; Medical research; Middle Aged; Mortality; Mortality - trends; Pneumonia; Pneumonia severity; Pneumonia, Pneumococcal - blood; Pneumonia, Pneumococcal - diagnosis; Pneumonia, Pneumococcal - mortality; Procalcitonin; Procalcitonin - blood; Prognosis; Proteins; Retrospective Studies; Severity of Illness Index; Streptococcus infections; Streptococcus pneumoniae; Ventilators; White blood cell count
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-018-1008-8

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. 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. 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