• Intensive care medicine · Mar 2006

    Procalcitonin kinetics in the prognosis of severe community-acquired pneumonia.

    • Nicolas Boussekey, Olivier Leroy, Serge Alfandari, Patrick Devos, Hugues Georges, and Benoit Guery.
    • Tourcoing Hospital, Intensive Care and Infectious Disease Unit, 135 rue du Président Coty BP 619, 59208, Tourcoing cedex, France. nboussekey@ch-tourcoing.fr
    • Intensive Care Med. 2006 Mar 1; 32 (3): 469-72.

    ObjectivesProcalcitonin (PCT) kinetics is a good prognosis marker in infectious diseases, but few studies of community-acquired pneumonia (CAP) have been performed in intensive care units (ICU). We analyzed the relationship between PCT kinetics and outcome in ICU patients with severe CAP.Design And SettingProspective observational study in a 16-bed university hospital ICU.Patients100 critically ill patients with community-acquired pneumonia.Measurements And ResultsMedian PCT was 5.2 ng/ml on day 1 and 2.9 ng/ml on day 3. It increased from day 1 to day 3 in nonsurvivors but decreased in survivors. In multivariate analysis four variables were associated with death: invasive ventilation (odds ratio 10-), multilobar involvement (5.6-), LOD score (6.9-), and PCT increase from day 1 to day 3 (4.5-). In intubated patients with a PCT level below 0.95 ng/ml on day 3 the survival rate was 95%.ConclusionIncreased PCT from day 1 to day 3 in severe CAP is a poor prognosis factor. A PCT level less than 0.95 ng/ml on day 3 in intubated patients is associated with a favorable outcome.

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