Procalcitonin predicts patients at low risk of death from community-acquired pneumonia across all CRB-65 classes

Authors:
  • SES Ewig
    S Ewig
  • RMR Marre
    R Marre
  • JPJ Papassotiriou
    J Papassotiriou
  • KRK Richter
    K Richter
  • HBH Von Baum
    H Von Baum
  • NSN Suttorp
    N Suttorp
  • TWT Welte
    T Welte
  • CGCAPNETZ Study Group
    CAPNETZ Study Group
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Abstract
The aim of the present study was to investigate the prognostic value, in patients with community-acquired pneumonia (CAP), of procalcitonin (PCT) compared with the established inflammatory markers C-reactive protein (CRP) and leukocyte (WBC) count alone or in combination with the CRB-65 (confusion, respiratory rate ≥30 breaths·min−1, low blood pressure (systolic value versus0.79 (0.74–0.84)), but each significantly higher compared with CRP (0.62 (0.54–0.68)) and WBC (0.61 (0.54–0.68)). PCT identified low-risk patients across CRB classes 0–4.In conclusion, procalcitonin levels on admission predict the severity and outcome of community-acquired pneumonia with a similar prognostic accuracy as the CRB-65 score and a higher prognostic accuracy compared with C-reactive protein and leukocyte count. Procalcitonin levels can provide independent identification of patients at low risk of death within CRB-65 (confusion, respiratory rate ≥30 breaths·min−1, low blood pressure (systolic value <90 mmHg or diastolic value ≤60 mmHg) and age ≥65 yrs) risk classes.

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