Source: Annual Congress 2008 - Factors related to outcome of community-acquired pneumonia
Disease area: Respiratory infections

Abstract

Rationale. Biological markers -procalcitonin PCT and C reactive protein CRP- have been recognized usefull to evaluate the response of host in community-acquired pneumonia (CAP).The objective of our study was to evaluate if biological markers PCT and/or CRP added to prognostic scales improve mortality prediction.
Methods. We performed a prospective cohort study in hospitalized patients with CAP in two tertiary care hospitals. We recorded age, gender, Fine risk class and CURB65. PCT and CRP were measured at day 1. 30 day mortality was the evaluated endpoint.
Results. 453 patients were included, 36 patients died within 30 days (7.8%). Medians of markers in groups with and without mortality were: CRP 21.9 vs 14.4 mg/dl (p=0.0001) and PCT 1.8 vs 0.58 ng/mL (P=0.002). Diagnostic value for predicting 30 day mortality was evaluated using the area under ROC curve (Table1). Adding levels of CRP to both prognostic scales (Fine and CURB65) significantly increased their value to 0.88.

Table 1. Areas under the ROC curve (AUC) of the different models to predict 30-days mortality

Model	AUC	95% CI
FINE	0.81	0.75-0.87
FINE + CRP *	0.85	0.80-0.91
FINE + PCT	0.83	0.77-0.89
CURB-65	0.82	0.76-0.89
CURB-65 + CRP #	0.86	0.81-0.92
CURB-65 + PCT	0.84	0.77-0.90

* p<0.05 for comparison of AUCs with that of FINE. # p<0.05 for comparison of AUCs with that of CURB-65

Conclusions. CRP levels might be usefully added to Fine risk class and CURB65 to increase mortality prediction.
Ciber CB06/06/0028.

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Citations should be made in the following way:
R. Menéndez, R. Martínez, S. Reyes, C. Esquinas, A. Martínez, J. Mensa, X. Filella, A. Torres (Valencia, Barcelona, Spain). Usefulness of C-reactive protein and procalcitonin in predicting mortality in community-acquired pneumonia. Eur Respir J 2008; 32: Suppl. 52, 1560

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