Prognostic value of procalcitonin combined with CURB-65 score in elderly patients with community acquired pneumonia

Abstract

Objective To evaluate the value of procalcitonin (PCT) combined with CURB-65 score in the elderly patients with community acquired pneumonia(CAP). Methods Seventy-eight elderly patients with CAP were selected in the Emergency Department of Xuanwu Hospital Capital Medical University, After admission, blood routine, PCT, blood gas analysis and biochemical examination were given, and Acute Physiology and Chronic Health Evaluation(APACHE Ⅱ) and CURB-65 score were carried out.According to the prognosis, the patients were divided into death group (16 cases) and survival group (62 cases), The difference of PCT, white blood cell(WBC), CURB-65 score and APACHE Ⅱ score in the two groups were compared.The differences of area under ROC curve of APACHE II score, procalcitonin (PCT), CURB-65 score, PCT and CURB-65 score were compared. Results The PCT, CURB-65 and APACHEE Ⅱ scores of the death group and the survival group were (3.35±1.79) μg/L vs.(2.05±1.89) μg/L, (2.06±0.85)points vs.(1.40±0.99) points, (20.50±4.06) points vs.(14.13+ 5.63) points, respectively.There were significant differences between the two groups (P<0.05). The number of WBCs in survival group and survival group were(9.90±3.04)×109 /L and(8.77±3.70)×109 /L, respectively, with no significant difference between the two groups (P=0.263); the area under the ROC curve of PCT predicting death was 0.716 (P=0.001), the area under the ROC curve of CURB-65 predicting death was 0.679 (P=0.005), and the area under the ROC curve of APACHE II score was 0.836 (P=0.001) , which was larger than PCT and CRUB-65 (P<0.05). The area under ROC curve of death predicted by PCT and CRUB-65 was 0.775 (P=0.001). There was no significant difference between PCT and CRUB-65 and APACHE II (P=0.345). Conclusion PCT combined with CURB-65 score can accurately and rapidly assess the condition of elderly patients with community-acquired pneumonia, and has important application value. Key words: CURB-65 score; Procalcitonin; APACHE Ⅱ score; CAP