Relation Between Clinical Pulmonary Infection Score, C-Reactive Protein, and Procalcitonin and Mortality in Patients With Hospital Acquired Pneumonia

CHEST Journal ◽  
2012 ◽  
Vol 142 (4) ◽  
pp. 224A
Author(s):  
Yavuz Havlucu ◽  
Aysin Coskun ◽  
Seher Cam ◽  
Nazmiye Gonen ◽  
Tugba Goktalay ◽  
...  
Keyword(s):  
Pulmonary Infection ◽  
Clinical Pulmonary Infection Score ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

scholarly journals Soluble urokinase plasminogen activator receptor for the prediction of ventilator-associated pneumonia

2019 ◽  
Vol 5 (1) ◽  
pp. 00212-2018 ◽  
Author(s):  
Pouline M. van Oort ◽  
Lieuwe D. Bos ◽  
Pedro Póvoa ◽  
Paula Ramirez ◽  
Antoni Torres ◽  
...  
Keyword(s):  
Plasminogen Activator ◽  
Critically Ill ◽  
Pulmonary Infection ◽  
Urokinase Plasminogen Activator ◽  
Clinical Pulmonary Infection Score ◽  
Ventilator Associated Pneumonia ◽  
C Reactive Protein ◽  
Urokinase Plasminogen Activator Receptor ◽  
Reactive Protein ◽  
Plasminogen Activator Receptor

IntroductionDiagnosing ventilator-associated pneumonia (VAP) remains challenging. Soluble urokinase plasminogen activator receptor (suPAR) has prognostic value in critically ill patients with systemic infection. We hypothesised that plasma suPAR levels accurately predict development of VAP.MethodsThis observational, multicentre, prospective cohort study compared patients at risk for VAP with a control group. Plasma and tracheal aspirate samples were collected. Plasma suPAR levels were measured on the day of diagnosis and 3 days before diagnosis.ResultsThe study included 24 VAP patients and 19 control patients. The suPAR concentration measured 3 days before diagnosis was significantly increased in VAP patients versus matched samples of control patients (area under the receiver operating characteristic curve (AUC) 0.68, 95% CI 0.52–1.00; p=0.04). Similar results were found on the day of diagnosis (AUC 0.77, 95% CI 0.6–0.93; p=0.01). Plasma suPAR was significantly higher in deceased patients (AUC 0.79, 95% CI 0.57–1.00; p<0.001). Combining suPAR with the Clinical Pulmonary Infection Score, C-reactive protein and/or procalcitonin led to a significantly increased discriminative accuracy for predicting VAP and an increased specificity.ConclusionssuPAR can be used to diagnose VAP with a fair diagnostic accuracy and has a moderate prognostic accuracy to be used in critically ill intensive care unit patients. Its performance improves when added to other clinically available biomarkers (C-reactive protein and procalcitonin) or scoring systems (Clinical Pulmonary Infection Score and Sepsis-related Organ Failure Assessment).

scholarly journals Procalcitonin and C-reactive Protein Perform Better Than Neutrophil-Lymphocyte Count Ratio on Evaluation of Hospital Acquired Pneumonia

2020 ◽  
Author(s):  
Nan Zheng ◽  
Dongmei Zhu New ◽  
YI HAN
Keyword(s):  
Lymphocyte Count ◽  
Diagnostic Performance ◽  
Multivariable Analysis ◽  
Previous History ◽  
Roc Curves ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Count Ratio ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Abstract Background: The relationship between biomarkers and hospital acquired pneumonia (HAP) is under studied, especially those severe cases admitted to the intensive care unit (ICU). Compared with community acquired pneumonia (CAP), HAP might have different traits regarding biomarkers due to the previous history in the hospitals. Methods: 593 adult patients were enrolled into this retrospective cohort study to determine neutrophil-lymphocyte count ratio (NLCR), procalcitonin (PCT), C-reactive protein (CRP) and serum lactate level at the admission of ICU. According to the diagnosis, patients were divided into two groups: non-infection and HAP. Discriminant analysis was performed based on better outcomes of diagnostic performance and severity evaluation. The diagnostic performance of each individual biomarker was assessed by construction of receiver operating characteristic (ROC) curves and calculation of the area under each ROC curves (AUROC). Multivariable analysis was also applied to determine most appropriate prognostic factors. Results: NLCR, PCT and CRP between non-infection and HAP group showed remarkable differences. Because of discriminant ability of severe infection, the AUROC of NLCR (0.626; 95%CI 0.581-0.671) was not comparative with conventional markers such as CRP (0.685; 95% CI 0.641-0.730) and PCT (0.661; 95% CI 0.615-0.707). Besides, AUROC of composite biomarkers, especially the combination of NLCR, CRP and WBC, were significantly greater than the single biomarkers. Conclusions: NLCR was not comparable to conventional single biomarkers such as CRP and PCT regarding to diagnosis or severity evaluation of HAP. Composite biomarkers could prompt early diagnosis and severity evaluation with improved accessibility, especially the combination of NLCR, CRP and WBC.

scholarly journals Procalcitonin and C-reactive Protein Perform Better Than Neutrophil-Lymphocyte Count Ratio on Evaluation of Hospital Acquired Pneumonia

2020 ◽  
Author(s):  
Nan Zheng ◽  
YI HAN
Keyword(s):  
Early Diagnosis ◽  
Roc Curves ◽  
Diagnostic Value ◽  
Apache Ii ◽  
Apache Ii Score ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Discriminant Ability ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Abstract Background: Early diagnosis and severity evaluation are key factors to achieve improved outcomes of hospital acquired pneumonia (HAP). We are constantly in search of more sensitive and specific biomarkers to improve timely diagnosis and survival.Methods: 593 cases of adult patients were enrolled into this retrospective cohort study to determine neutrophil-lymphocyte count ratio (NLCR), procalcitonin (PCT), C-reactive protein (CRP), serum lactate level and APACHE (Acute Physiology and Chronic Health Evaluation) II score at the admission of ICU. Patients were divided into 2 groups according to diagnosis: non-infection and HAP. Discriminant analysis was applied to which marker or what composition of markers performed better regarding to the diagnostic value and severity evaluation. The diagnostic value of each individual biomarker was assessed by construction of receiver operating characteristic (ROC) curves, calculation of the area under each ROC curves (AUROC). Multivariate analysis was also applied to detect most appropriate prognostic factors.Results: Remarkable differences were observed on NLCR, PCT, CRP and APACHE II scores between non-infection and HAP group. Regarding to discriminant ability of severe infection, the AUROC of NLCR (0.56; 95%CI 0.52-0.61) was not comparative with any of other single markers such as PCT (0.63; 95% CI 0.59-0.68), CRP (0.60; 95% CI 0.54-0.67), or APACHE II score (0.68; 95% CI 0.64-0.73). Compared to the single biomarkers, APACHE II score presented higher discriminant ability with greater AUROC. Besides, AUROC of the composite biomarker PCT-CRP-NLCR (0.66; 95% CI 0.61-0.70) was significantly greater than any of the single biomarkers, and its discriminant ability was comparable to APACHE II score.Conclusions: NLCR is not comparable to other single biomarkers such as PCT, CRP, or APACHE II score regarding to diagnosis or to severity evaluation of HAP. Composite biomarkers can prompt early diagnosis and severity evaluation with improved accessibility, especially the composition of PCT-CRP-NLCR.

scholarly journals Diagnostic efficacy of serum procalcitonin, C-reactive protein concentration and clinical pulmonary infection score in Ventilator-Associated Pneumonia

2018 ◽  
Vol 34 ◽  
pp. 26-32 ◽  
Author(s):  
Changqin Chen ◽  
Molei Yan ◽  
Caibao Hu ◽  
Xiaochun Lv ◽  
Huihui Zhang ◽  
...  
Keyword(s):  
Serum Level ◽  
Pathogenic Bacteria ◽  
Pulmonary Infection ◽  
Clinical Pulmonary Infection Score ◽  
Diagnostic Sensitivity ◽  
Ventilator Associated Pneumonia ◽  
C Reactive Protein ◽  
Diagnostic Efficacy ◽  
Reactive Protein ◽  
Sensitivity Specificity

Objective: The aim of this study was to evaluate the diagnostic efficacy of serum procalcitonin (PCT), c-reactive protein (CRP) concentration and clinical pulmonary infection score(CPIS) in ventilator-associated pneumonia(VAP). Methods: Forty-nine patients who were admitted to the intensive care unit (ICU) of Zhejiang Hospital with suspected VAP were recruited in this study. The serum level of PCT and CRP of all patients were measured and CPIS was calculated at the time of VAP suspected diagnosis. Of the included 49 patients, 24 were finally confirmed of VAP by microbiology assay. And the other 25 patients were considered as clinical suspected VAP without microbiology confirmation. The diagnostic sensitivity, specificity and area under the receiver operating characteristic (ROC) curve (AUC) were calculated using the serum PCT, CRP concentration and CPIS. The correlation among serum PCT, CRP concentration and CPIS were also evaluated by Spearson correlation test. Results: A total of 100 bronchoscopic aspiration sputum specimen were examined in bacterial culture. 30 samples were found with suspected pathogenic bacteria. Six samples were found with 2 types of suspected pathogenic bacteria. PCT serum concentration and CPIS score were significantly different (P<0.05) between the patient group [1.4 (0.68 ∼ 2.24), 6.0 (4.25 ∼ 8.00)] and the control group [0.4 (0.17 ∼ 1.39), 3.0 (1.00 ∼ 5.00)] ; However, the serum CRP [102.8(66.75 ∼ 130.90) vs 86.1(66.95 ∼ 110.10)] was not statistically different between the two groups (P>0.05). A significant correlation was found between serum PCT and CRP concentrations (r=0.55, P<0.01), but not between PCT vs CPIS and CRP vs CPIS (p>0.05). The diagnostic sensitivity, specificity and AUC were 72.0%, 75.0%, 0.81 (0.69 ∼ 0.93) for CPIS; 60.0%, 87.5%, 0.76 (0.62 ∼ 0.90) for PCT and 68.0%, 58.3%, 0.59 (0.43 ∼ 0.76) for CRP. Conclusion: PCT serum level and CPIS score are elevated in VAP patients and could therefore represent potential biomarkers for VAP early diagnosis.

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