Correlation and Assessment of Cost-Effectivity of Simultaneous PCT and CRP Measurements for Patients with Community-Acquired Pneumonia and COPD Inflamation

Abstract

Objective: Bacterial infections are important causes of morbidity and mortality. Serum procalcitonin and C-reactive protein are significant indicators during the diagnosis, treatment and follow-up of systemic inflammations and bacterial infections. In this study, correlation between levels of procalcitonin, which has recently become commonly used in infection cases, and C-reactive protein, the conventional indicator, were investigated for patients whose final diagnoses were found as pneumonia and/or COPD inflammation. Additionally, the study aimed to determine which among the two indicators was cost-effective for the diagnosis and management of lower respiratory infections.

Material and Methods: Procalcitonin and C-reactive protein results of 4712 samples, which were gathered from 1948 patients and measured simultaneously were assessed. Among the samples, 499 (10.6%) were from COPD inflammation patients (Group I), 1480 (31.4%) were from pneumonia patients (Group II), and the remaining 2733 (58%) were from COPD inflammation and pneumonia patients (Group III).

Results: A strong positive correlation was detected between C-reactive protein and procalcitonin levels (rho=0.512, p<0.001). As for the assessments within the established groups I, II and III, again a strong positive correlation was seen (rho=0.539, p<0.001; rho=0.509, p<0.001; rho=0.511, p<0.001, respectively).

Conclusion: Procalcitonine was found to be positively correlated to C-reactive protein and it was suggested that procalcitonine could be used instead of the costly C reactive protein during long-term infection care.

Keywords

• Community-acquired pneumonia,COPD inflammation,procalcitonin,C-reactive protein

EŞ ZAMANLI PCT VE CRP İSTENEN TOPLUM KÖKENLİ PNÖMONİ VE KOAH ALEVLENMESİ OLAN HASTALARDA BU PARAMETRELERİN KORELASYONU VE MALİYET ETKİLİLİK AÇISINDAN DEĞERLENDİRİLMESİ

Abstract

Amaç: Bakteriyel enfeksiyonlar önemli morbidite ve mortalite nedenidir. Serum prokalsitonin ve C-reaktif protein sistemik inflamasyon ve bakteriyel enfeksiyonların tanı, tedavi ve takibinde önemli belirteçlerdir. Bu çalışmada nihai tanıları pnömoni ve/veya KOAH alevlenmesi olan hastalarda son zamanlarda enfeksiyon takibinde sıklıkla kullanılmaya başlanan prokalsitonin ile klasik belirteç olarak kullanılan C-reaktif protein düzeyleri arasındaki korelasyon araştırıldı. Ayrıca alt solunum yolu enfeksiyonu tanısı ya da yönetimi için C-reaktif proteinin mi, prokalsitoninin mi maliyet etkililik açısından yararlı olduğunu saptamayı amaçladık.

Gereç ve Yöntemler: Toplam 1948 hastadan elde edilmiş 4712 örnekten eş zamanlı çalışılan prokalsitonin ve C-reaktif protein sonuçları değerlendirildi. Örneklerden 499’u (%10.6) KOAH alevlenmesi (Grup I), 1480’i (%31.4) pnömoni (Grup II) ve 2733 (%58)’i KOAH alevlenmesi ve pnömoni (Grup III) tanısı almış hastaların örneklerinden oluşuyordu.

Bulgular: C-reaktif protein ve prokalsitonin düzeyleri arasında pozitif güçlü korelasyon saptandı (rho=0.512, p<0.001). Yine prokalsitonin ve C-reaktif protein arasındaki grup içi değerlendirmede Grup I, Grup II ve Grup III’de pozitif güçlü korelasyon tespit edildi (sırasıyla rho=0.539, p<0.001; rho=0.509, p<0.001; rho=0.511, p<0.001).

Sonuç: Prokalsitoninin C-reaktif protein ile korelasyon gösterdiği, enfeksiyonun ileri dönem takibinde yüksek maliyetli prokalsitonin yerine C-reaktif protein ölçümünün kullanılmasının uygun olacağı kanaatine varılmıştır.

Keywords

• KOAH alevlenmesi,Toplum kökenli pnömoni,prokalsitonin,C-reaktif protein

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