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Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital
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....
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| Published in: | BMC geriatrics 2019-01, Vol.19 (1), p.3-3, Article 3 |
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| creator | Akagi, Takanori Nagata, Nobuhiko Miyazaki, Hiroyuki Harada, Taishi Takeda, Satoshi Yoshida, Yuji Wada, Kenji Fujita, Masaki Watanabe, Kentaro |
| description | 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 |
| doi_str_mv | 10.1186/s12877-018-1008-8 |
| format | article |
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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 < 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.
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.</description><identifier>ISSN: 1471-2318</identifier><identifier>EISSN: 1471-2318</identifier><identifier>DOI: 10.1186/s12877-018-1008-8</identifier><identifier>PMID: 30616612</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>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</subject><ispartof>BMC geriatrics, 2019-01, Vol.19 (1), p.3-3, Article 3</ispartof><rights>COPYRIGHT 2019 BioMed Central Ltd.</rights><rights>Copyright © 2019. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s). 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c560t-e0dc564eeaa11c70751211078f3c20381ea75bd858c2ffa6e2110ee203cd47db3</citedby><cites>FETCH-LOGICAL-c560t-e0dc564eeaa11c70751211078f3c20381ea75bd858c2ffa6e2110ee203cd47db3</cites><orcidid>0000-0001-8402-8278</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323702/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2168575550?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25752,27923,27924,37011,37012,44589,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30616612$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Akagi, Takanori</creatorcontrib><creatorcontrib>Nagata, Nobuhiko</creatorcontrib><creatorcontrib>Miyazaki, Hiroyuki</creatorcontrib><creatorcontrib>Harada, Taishi</creatorcontrib><creatorcontrib>Takeda, Satoshi</creatorcontrib><creatorcontrib>Yoshida, Yuji</creatorcontrib><creatorcontrib>Wada, Kenji</creatorcontrib><creatorcontrib>Fujita, Masaki</creatorcontrib><creatorcontrib>Watanabe, Kentaro</creatorcontrib><title>Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital</title><title>BMC geriatrics</title><addtitle>BMC Geriatr</addtitle><description>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 < 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.
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.</description><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Albumin</subject><subject>Antibiotics</subject><subject>Bacterial infections</subject><subject>Biomarkers</subject><subject>Biomarkers - blood</subject><subject>Blood</subject><subject>Body mass index</subject><subject>C-reactive protein</subject><subject>Community-acquired infections</subject><subject>Community-Acquired Infections - blood</subject><subject>Community-Acquired Infections - diagnosis</subject><subject>Community-Acquired Infections - mortality</subject><subject>Demographic aspects</subject><subject>Elderly</subject><subject>Elderly patients</subject><subject>Female</subject><subject>Geriatrics</subject><subject>Hemodialysis</subject><subject>Hospitalization - trends</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Intensive care</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Mortality - trends</subject><subject>Pneumonia</subject><subject>Pneumonia severity</subject><subject>Pneumonia, Pneumococcal - blood</subject><subject>Pneumonia, Pneumococcal - diagnosis</subject><subject>Pneumonia, Pneumococcal - mortality</subject><subject>Procalcitonin</subject><subject>Procalcitonin - blood</subject><subject>Prognosis</subject><subject>Proteins</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Streptococcus infections</subject><subject>Streptococcus pneumoniae</subject><subject>Ventilators</subject><subject>White blood cell count</subject><issn>1471-2318</issn><issn>1471-2318</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptkk1v1DAQhiMEoqXwA7ggS1w4kOKJ44-9IFUVH5UqwQHOluNMdr1K4tR2ivbP8Ftx2LLsImTJHs2889hjvUXxEuglgBLvIlRKypKCKoFSVapHxTnUEsqKgXp8FJ8Vz2LcUgpSVeJpccaoACGgOi9-fg3emt665Ec3EhfJ6BMxORpbnDBvYyJTwNbZ5APxHWG0bM2ODD4k07u0e0tM36A7qCKZRpyHjDMk4j2GrMk0MpnkMiySHy5tjjTG3s0utxI_p-haJGmDZOPj5DL_efGkM33EFw_nRfH944dv15_L2y-fbq6vbkvLBU0l0jYHNaIxAFZSyaECoFJ1zFaUKUAjedMqrmzVdUbgUkXMJdvWsm3YRXGz57bebPUU3GDCTnvj9O-ED2ttQnK2Ry0b1jRWAuuEqaVsVF2vVtCsuBKC1o3IrPd71jQ3A7Y2Dx1MfwI9rYxuo9f-XgtWMUmrDHjzAAj-bsaY9OCixb43I_o56goEp1xVTGXp63-kWz-HMX_VolJccs7pX9Xa5AHc2Pl8r12g-oorYKuVFDyrLv-jyqvFwVk_Yudy_qQB9g02-BgDdocZgerFoHpvUJ0NqheD6uXBr44_59Dxx5HsFwF74tQ</recordid><startdate>20190107</startdate><enddate>20190107</enddate><creator>Akagi, Takanori</creator><creator>Nagata, Nobuhiko</creator><creator>Miyazaki, Hiroyuki</creator><creator>Harada, Taishi</creator><creator>Takeda, Satoshi</creator><creator>Yoshida, Yuji</creator><creator>Wada, Kenji</creator><creator>Fujita, Masaki</creator><creator>Watanabe, Kentaro</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-8402-8278</orcidid></search><sort><creationdate>20190107</creationdate><title>Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital</title><author>Akagi, Takanori ; Nagata, Nobuhiko ; Miyazaki, Hiroyuki ; Harada, Taishi ; Takeda, Satoshi ; Yoshida, Yuji ; Wada, Kenji ; Fujita, Masaki ; Watanabe, Kentaro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c560t-e0dc564eeaa11c70751211078f3c20381ea75bd858c2ffa6e2110ee203cd47db3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Albumin</topic><topic>Antibiotics</topic><topic>Bacterial infections</topic><topic>Biomarkers</topic><topic>Biomarkers - blood</topic><topic>Blood</topic><topic>Body mass index</topic><topic>C-reactive protein</topic><topic>Community-acquired infections</topic><topic>Community-Acquired Infections - blood</topic><topic>Community-Acquired Infections - diagnosis</topic><topic>Community-Acquired Infections - mortality</topic><topic>Demographic aspects</topic><topic>Elderly</topic><topic>Elderly patients</topic><topic>Female</topic><topic>Geriatrics</topic><topic>Hemodialysis</topic><topic>Hospitalization - trends</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Intensive care</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Mortality - trends</topic><topic>Pneumonia</topic><topic>Pneumonia severity</topic><topic>Pneumonia, Pneumococcal - blood</topic><topic>Pneumonia, Pneumococcal - diagnosis</topic><topic>Pneumonia, Pneumococcal - mortality</topic><topic>Procalcitonin</topic><topic>Procalcitonin - blood</topic><topic>Prognosis</topic><topic>Proteins</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Streptococcus infections</topic><topic>Streptococcus pneumoniae</topic><topic>Ventilators</topic><topic>White blood cell count</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Akagi, Takanori</creatorcontrib><creatorcontrib>Nagata, Nobuhiko</creatorcontrib><creatorcontrib>Miyazaki, Hiroyuki</creatorcontrib><creatorcontrib>Harada, Taishi</creatorcontrib><creatorcontrib>Takeda, Satoshi</creatorcontrib><creatorcontrib>Yoshida, Yuji</creatorcontrib><creatorcontrib>Wada, Kenji</creatorcontrib><creatorcontrib>Fujita, Masaki</creatorcontrib><creatorcontrib>Watanabe, Kentaro</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest - Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>BMC geriatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Akagi, Takanori</au><au>Nagata, Nobuhiko</au><au>Miyazaki, Hiroyuki</au><au>Harada, Taishi</au><au>Takeda, Satoshi</au><au>Yoshida, Yuji</au><au>Wada, Kenji</au><au>Fujita, Masaki</au><au>Watanabe, Kentaro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital</atitle><jtitle>BMC geriatrics</jtitle><addtitle>BMC Geriatr</addtitle><date>2019-01-07</date><risdate>2019</risdate><volume>19</volume><issue>1</issue><spage>3</spage><epage>3</epage><pages>3-3</pages><artnum>3</artnum><issn>1471-2318</issn><eissn>1471-2318</eissn><abstract>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 < 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.
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.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>30616612</pmid><doi>10.1186/s12877-018-1008-8</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0001-8402-8278</orcidid><oa>free_for_read</oa></addata></record> |
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| 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 |
| title | Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital |
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