Prognostic value of procalcitonin in respiratory tract infections across clinical settings

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• 作者：Alexander Kutz (1)
  Matthias Briel (2)
  Mirjam Christ-Crain (3)
  Daiana Stolz (4)
  Lila Bouadma (5)
  Michel Wolff (5)
  Kristina B Kristoffersen (6)
  Long Wei (7)
  Olaf Burkhardt (8)
  Tobias Welte (8)
  Stefan Schroeder (9)
  Vandack Nobre (10)
  Michael Tamm (4)
  Neera Bhatnagar (11)
  Heiner C Bucher (2)
  Charles-Edouard Luyt (12)
  Jean Chastre (12)
  Florence Tubach (13)
  Beat Mueller (1)
  Philipp Schuetz (1)
  
  1. University Department of Medicine ; Kantonsspital Aarau ; Tellstrasse ; 5001 ; Aarau ; Switzerland
  2. Basel Institute for Clinical Epidemiology and Biostatistics ; University Hospital Basel ; Hebelstrasse 10 ; Basel ; 4031 ; Switzerland
  3. Division of Endocrinology ; Diabetology and Clinical Nutrition ; University Hospital Basel ; Hebelstrasse 10 ; Basel ; 4031 ; Switzerland
  4. Clinic of Pneumology and Pulmonary Cell Research ; University Hospital Basel ; Hebelstrasse 10 ; Basel ; 4031 ; Switzerland
  5. Service de R茅animation M茅dicale ; Universit茅 Paris 7鈥揇enis Diderot ; H么pital Bichat鈥揅laude-Bernard ; Assistance Publique鈥揌么pitaux de Paris (AP鈥揌P) ; Henri Huchard Paris Cedex 18 ; Paris ; 75877 ; France
  6. Department of Infectious Diseases ; Aarhus University Hospital ; Skejby ; Palle Juul-Jensens Boulevard 99 ; 8200 ; Aarhus N ; Denmark
  7. Department of Internal and Geriatric Medicine ; Shanghai Jiao Tong University Affiliated Sixth People鈥檚 Hospital ; Huan Hu Xi San Road ; Pudong New Area ; Shanghai ; 201306 ; China
  8. Department of Pulmonary Medicine ; Hannover Medical School ; Carl-Neuberg-Str. 1 ; Hannover ; 30659 ; Germany
  9. Department of Anesthesiology and Intensive Care Medicine ; D眉ren Hospital ; Roonstra脽e 30 ; D眉ren ; 52351 ; Germany
  10. Intensive Care ; Universidade Federal de Minas Gerais ; 6627 - Pampulha ; Belo Horizonte - MG ; 31270-901 ; Brazil
  11. Department of Clinical Epidemiology and Biostatistics ; McMaster University ; 1280 Main Street West ; Hamilton ; Ontario ; L8S4L8 ; Canada
  12. Service de R茅animation M茅dicale ; Universit茅 Paris 6鈥揚ierre et Marie Curie ; H么pital Piti茅鈥揝alp锚tri猫re ; AP-HP ; 47-83 boulevard de l鈥橦么pital ; Paris ; 75651 ; France
  13. AP-HP ; H么pitaux Universitaires Paris Nord Val de Seine ; D茅partement d鈥橢pid茅miologie Biostatistique et Recherche Clinique ; Universit茅 Paris Diderot ; Sorbonne Paris Cit茅 ; UMR 738 ; INSERM ; UMR 738 ; INSERM ; CIE801 ; 5 Rue Thomas Mann ; Paris ; Cedex 13 ; 75013 ; France
  
• 刊名：Critical Care
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：19
• 期：1
• 全文大小：1,161 KB
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• 刊物主题：Intensive / Critical Care Medicine; Emergency Medicine;
• 出版者：BioMed Central
• ISSN：1364-8535

文摘

Introduction Whether the inflammatory biomarker procalcitonin provides prognostic information across clinical settings and different acute respiratory tract infections (ARIs) is poorly understood. In the present study, we investigated the prognostic value of admission procalcitonin levels to predict adverse clinical outcome in a large ARI population. Methods We analysed data from 14 trials and 4,211 ARI patients to study associations of admission procalcitonin levels and setting specific treatment failure and mortality alone at 30聽days. We used multivariable hierarchical logistic regression and conducted sensitivity analyses stratified by clinical settings and ARI diagnoses to assess the results鈥?consistency. Results Overall, 864 patients (20.5%) experienced treatment failure and 252 (6.0%) died. The ability of procalcitonin to differentiate patients with from those without treatment failure was highest in the emergency department setting (treatment failure area under the curve (AUC): 0.64 (95% confidence interval (CI): 0.61, 0.67), adjusted odds ratio (OR): 1.85 (95% CI: 1.61, 2.12), P P P Conclusions Admission procalcitonin levels are associated with setting specific treatment failure and provide the most prognostic information regarding ARI in the emergency department setting.