Prognostic value of serum procalcitonin and C-reactive protein levels in critically ill patients who developed ventilator-associated pneumonia
Hakan Tanriverdi1, Müge Meltem Tor1, Levent Kart2, Remzi Altin3, Figen Atalay1, Vildan SumbSümbüloglu4
1 Department of Chest Diseases, Bülent Ecevit University, Faculty of Medicine, Zonguldak, Turkey
2 Department of Chest Diseases, Fatih University, Faculty of Medicine, Istanbul, Turkey
3 Department of Chest Diseases, Namik Kemal University, Faculty of Medicine, Tekirdag, Turkey
4 Department of Biostatistic, Bülent Ecevit University, Faculty of Medicine, Zonguldak, Turkey
Departments of Chest Diseases, Bülent Ecevit University, Faculty of Medicine, Bülent Ecevit Universitesi sa?l?k kampüsü, Esenköy - 67100, Kozlu, Zonguldak
Source of Support: None, Conflict of Interest: None
INTRODUCTION: Ventilator-associated pneumonia (VAP) is an important cause of mortality and morbidity in critically ill patients. We sought to determine the prognostic value of procalcitonin (PCT) and C-reactive protein (CRP) kinetics in critically ill patients who developed VAP.
METHODS: Patients who were admitted to the intensive care unit (ICU) and developed VAP were eligible. Patients were followed for 28 days after the pneumonia diagnosis and blood samples for PCT and CRP were collected on the day of the pneumonia diagnosis (D0), and days 3 (D3) and 7 (D7) after the diagnosis. Patients were grouped as survivors and non-survivors, and the mean PCT and CRP values and their kinetics were assessed.
RESULTS: In total, 45 patients were enrolled. Of them, 22 (48.8%) died before day 28 after the pneumonia diagnosis. There was no significant difference between the survivor and non-survivor groups in terms of PCT on the day of pneumonia diagnosis or CRP levels at any point. However, the PCT levels days 3 and 7 were significantly higher in the non-survivor group than the survivor group. Whereas PCT levels decreased significantly from D0 to D7 in the survivor group, CRP did not. A PCT level above 1 ng/mL on day 3 was the strongest predictor of mortality, with an odds ratio of 22.6.
CONCLUSION: Serum PCT was found to be a superior prognostic marker compared to CRP in terms of predicting mortality in critically ill patients who developed VAP. The PCT level on D3 was the strongest predictor of mortality in VAP.