Abstract
BackgroundTo predict the prognosis by observing the dynamic change of C-reactive protein (CRP) and procalcitonin (PCT) for hospitalized community-acquired pneumonia (CAP).MethodsThe data were collected from January to December 2017 from the first affiliated Hospital of Zhengzhou University. Demographic and clinical patient information including age, length of hospital stay and Charlson Comorbidity Index (CCI) were recorded. Blood samples were taken for CRP, PCT, and white blood cell count (WBC). Receiver Operating Characteristic (ROC) curve was used to verify each biomarker’s association with the prognosis of pneumonia.ResultsA total of 350 patients were enrolled in the study. The 30-day mortality was 10.86%. Serial serum CRP3, CRP5, PCT3, PCT5 and PCT5c levels were statistically lower in CAP survivors than non-survivors. CRP3c < 0, CRP5c < 0 and PCT5c < 0 were observed with a statistically lower frequency in patients with 30-day mortality and initial treatment failure. The AUC for 30-day mortality for serial CRP levels combined with CRP clearances was 0.85 (95% CI 0.77–0.92), as compared to an AUC of 0.81 (95% CI 0.73–0.9) for serial PCT levels combined with PCT clearances.ConclusionsSerum serial CRP and PCT levels had moderate predictive value for hospitalized CAP prognosis. The dynamic CRP and PCT changes may potentially be used in the future to predict hospitalized CAP prognosis.
Highlights
To predict the prognosis by observing the dynamic change of C-reactive protein (CRP) and procalcitonin (PCT) for hospitalized community-acquired pneumonia (CAP)
Similar to PCT clearance (PCTc) in the previous study, in our study we introduced CRP clearance (CRPc) to monitor the changes of CRP levels during the treatment of hospitalized CAP
Serial serum CRP3, CRP5, PCT3, PCT5 and PCT5c levels were statistically lower in CAP survivors than non-survivors (Table 1)
Summary
To predict the prognosis by observing the dynamic change of C-reactive protein (CRP) and procalcitonin (PCT) for hospitalized community-acquired pneumonia (CAP). Diagnosis of pneumonia in critically ill patients is usually challenging. Biomarkers of inflammation or infection, such as procalcitonin (PCT) and C-reactive protein (CRP), have been proposed as a guide in the diagnostic process [4,5,6]. Elevated serum PCT and CRP were associated with community-acquired pneumonia and ventilator-associated pneumonia (VAP) [5, 7]. CRP is a well-established biomarker in many clinical settings, but has been traditionally considered insufficient as a useful marker in the diagnosis of pneumonia. All infections, stress reactions, autoimmunity and tumor disease can contribute to the increase in serum CRP values [8]
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