Relationship Of The Procalcitonin Level On Admission With Curb-65 and Smart- Cop Scores In Hospitalized Patients With Pneumonia

Abstract

Study Objectives Know the result of disease severity and clinical results in community-acquired pneumonia (CAP) are preconditions for treatment options and management for health care resources. Various scoring systems as CURB-65 and SMART-COP have been developed to facilitate these awareness. We aimed to investigate the relationship between these two scoring systems with procalcitonin level in the diagnosis of CAP. Methods Study included hospitalized patients diagnosis CAP that had been admitted to the emergency department between 01.01.2015 - 12.31.2015. CURB-65 and SMART-COP scores were calculated. We collected measured procalcitonin levels. As described previously during the study, patients who had 2 and over values for CURB-65 and who had values 3 or more for SMART-COP were classified as high risk and groupings were structured according to these values. Results The study was conducted on a total of 124 cases. 72 of the cases had a CURB-65 score of 2 or more and 49 of the cases had a SMART-COP score of 3 or above. The cases’ procalcitonin levels which had 2 ng/ml or above scores for CURB-65 had higher statistical significance than the cases that had 2 or less scores for CURB-65 (P: 0,004; p<0,05). The cases’ procalcitonin levels that had 3 or above scores for SMART-COP had higher statistical significance than the cases which had 2 or less scores for SMART-COP (p: 0,001; p<0,05). Conclusions High procalcitonin levels were associated with the patients who had high scores in both scoring systems, and had a relationship with the severity and course of the disease.

Keywords

• Procalcitonin
• Pneumonia
• Curb-65
• Smart-Cop Score

References

1. 1. Hobbs FB. Population profile of United States: The elderly population. US Census Bureau. http://www.census.gov/ population/ www/popprofile/ elderpop.html.
2. 2. Farr BM, Slomen AJ, Fisch MJ, et al. Predicting death in patients hospitalized for community-acquired pneumonia. Ann Intern Med 1991; 115: 428-36.
3. 3. Pinner RW,Teutsch SM, Simonsen L,et al. Trends in infectious diseases mortality in the United States. JAMA 1996; 275: 189-93.
4. 4. Lim WS, Baudouin SV , George RC , Hill A T , Jamieson C, Le Jeune I , et al . BTS guidelines for the management of community acquired pneumonia in adults. Thorax 2009; 64(3): 1-55.
5. 5. Türk Toraks Derneği. Toplumda Gelişen Pnömoni Tanı ve Tedavi Uzlaşı Raporu. Türk Toraks Dergisi 2009; 10(9): 3-12.
6. 6. Schuetz P, Suter-Widmer I, Chaudri A, M. Christ-Crain, W. Zimmerli and B.Mueller Prognostic value of procalcitonin in community-acquired pneumonia ERJ 2011; 37: 384-92.
7. 7. Fine MJ., Auble TE., Yealy DM., ve ark. A prediction rulet o identfy low-risk patients with community-acquaired pneumonia. N Engl J Med. 1997; 336; 243-50.
8. 8. Lim WS., Van der Eerden MM., Laing R. Ve ark. Defining community-acquaired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax 2003; 58: 377-82.

9. 9. Patrick G. P. Charles,1,3 Rory Wolfe,4 Michael Whitby,7 Michael J. Fine,14,15 Andrew J. Fuller,9 et all. SMART-COP: A Tool for Predicting the Need for Intensive Respiratory or Vasopressor Support in Community-Acquired Pneumonia Predicting the Need for IRVS in CAP • CID 2008:47 375-84.
10. 10. Marrie TJ. Epidemiology of mild pneumonia. Semin Respir Infect 1998; 13: 3-7.
11. 11. Furth R, van den Broek PI. Aetiology of community acquired pneumonia: a prospective study among adults requiring admission to hospital. Thorax 1995; 50: 540-7.
12. 12. Yenen Ş, Çalangu S, Eraksoy H ve ark. İnfeksiyon hastalıklarında akut faz reaktanları. İnfeksiyon hastalıkları, Alemdar Ofset, 1990; 21-42.
13. 13. Brunkhorst FM, Al-Nawas B, Krummenauer F, et al. Procalcitonin, C-reactive protein and APACHE II score for risk evaluation in patients with severe pneumonia. Clin Microbiol Infect 2002; 8: 93-100.
14. 14. Kasamatsu Y. Usefulness of a semi-quantitative procalcitonin test and the A-DROP Japanese prognostic scale for predicting mortality among adults hospitalized with community-acquired pneumonia. Respirology 2012; 17 (2): 330-36. 15. Kim JH. Usefulness of Plasma Procalcitonin to Predict Severity in Elderly Patients with Community-Acquired Pneumonia. Tuberc Respir Dis (Seoul) 2013; 74: 207–14.
15. 16. Yang Y, Xu F, Shi LY, Diao R, Cheng YS, Chen XY, et al. Efficacy and significance of various scores for pneumonia severity in the management of patients with community-acquired pneumonia in China. Chin Med J (Engl) 2012; 125 (4): 639-45.
16. 17. Buising KL, Thursky KA, Black JF, MacGregor L, Street AC, Kennedy MP, et al. A prospective comparison of severity scores for identifying patients with severe community acquired pneumonia: reconsidering what is meant by severe pneumonia. Thorax 2006; 61(5): 419- 24.
17. 18. Soni NJ, Samson DJ, Galaydick JL, Vats V, Pitrak DL, Aronson N. Procalcitonin-Guided Antibiotic Therapy [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Oct. (Comparative Effectiveness Reviews, No. 78.) Summary and Discussion. Available from: http://www.ncbi.nlm.nih.gov/books/NBK114999/.
18. 19. Viasus D, del Rio-Pertuz G, Simonetti AF, García-Vidal C, Acosta-Reyes J, Garavito A, et al. Biomarkers for predicting short-term mortality in community-acquired pneumonia: a systematic review and meta-analysis. J Infect. 2016; 72: 273-82.
19. 20. HamidReza Naderi,Fereshte Sheybani,MohammadReza Servghad,MehdiJabari Nooghabi Can Procalcitonin Add to the Prognostic Power of the Severity Scoring System in Adults with Pneumonia? Tanaffos 2015; 14(2): 95-106.
20. 21. Johansson N, Kalin M, Backman-Johansson C, Larsson A, Nilsson K, Hedlund J Procalcitonin levels in community-acquired pneumonia – correlation with aetiology and severity Scandinavian Journal of Infectious Diseases, 2014; 46: 787-791.
21. 22. Julián-Jiménez A, González Del Castillo J, Candel FJ Usefulness and prognostic value of biomarkers in patients with community-acquired pneumoniain the emergency department Med Clin (Barc). 2017 ;148(11): 501-510.
22. 23. Karen L. Robins-Browne, Allen C. Cheng, Kathleen A. S. Thomas, Didier J. Palmer, Bart J. Currie, Joshua S. Davis The SMART-COP score performs well for pneumonia risk stratification in Australia’s Tropical Northern Territory: a prospective cohort study Tropical Medicine and International Health 2012: 17 (7): 914-9.
23. 24. Dan Liu, Long-Xıang Su, Wei Guan, Kun Xiao, Li-Xin Xie Prognostic value of procalcitonin in pneumonia: A systematicrewiev and meta-analysis Respirology 2016; 21: 280-8.