Abstract

Background: Pneumonia is an infectious disease with high mortality rates despite early diagnosis and adequate treatment. Therefore, the use of biological infection parameters is expected to improve patients' clinical outcome prognostic accuracy. In this study, we proposed a combination of decreased procalcitonin (PCT) and C-reactive protein (CRP) to predict the clinical outcome of severe pneumonia. Methods: This was a prospective cohort study of severe pneumonia patients treated in the singlecenter Intensive Care Unit (ICU) of Dr. Soetomo General Hospital from December 2023 to February 2024. Subjects who met the inclusion and exclusion criteria were examined for PCT and CRP within the first 24 hours of admission and repeated 96 hours later (day five). Clinical outcomes, including acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), sep. tic shock, and 30-day mortality, were observed. Results: Thirty-five patients were enrolled for this study. Five subjects did not survive until the fifth day, and 30 subjects were eligible for analysis. A decrease of PCT >50% within five days was associated with a reduction of 30-day mortality (p=0.013) and septic shock incidence (p=0.005), whereas the decrease in CRP alone did not show any significant relationship towards any clinical outcome. The combination of a decreased PCT >50% and decreased CRP within five days could increase the prognostic specificity up to 88.9% in predicting 30-day mortality. Conclusion: Decreased PCT by more than 50% within 96 hours may predict the 30-day mortality rate and septic shock incidence in patients with severe pneumonia, while combining it with a decreased CRP expression would elevate prognostic specificity for severe pneumonia.

Original languageEnglish
Pages (from-to)157-166
Number of pages10
JournalCritical Care and Shock
Volume27
Issue number4
Publication statusPublished - Aug 2024

Keywords

  • Decreased procalcitonin
  • Intensive Care Unit
  • decreased CRP
  • severe pneumonia

Fingerprint

Dive into the research topics of 'A combined parameter of changes in procalcitonin and C-reactive protein (CRP) in predicting the clinical outcome of severe pneumonia'. Together they form a unique fingerprint.

Cite this