Annals of Emergency Medicine
Volume 52, Issue 1 , Pages 48-58.e2 , July 2008

Risk Prediction With Procalcitonin and Clinical Rules in Community-Acquired Pneumonia

Presented at the American College of Emergency Physicians Research Forum, October 2006, New Orleans, LA.

  • David T. Huang, MD, MPH

      Affiliations

    • Clinical Research, Investigation, and Systems Modeling of Acute Illness Laboratory, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA
    • Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA
    • Corresponding Author InformationAddress for correspondence: David T. Huang, MD, MPH, Room 646B Scaife Hall, The CRISMA Laboratory, Department of Critical Care Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA 15261; 412-647-6818, fax 412-647-3791
    • ,
  • Lisa A. Weissfeld, PhD

      Affiliations

    • Clinical Research, Investigation, and Systems Modeling of Acute Illness Laboratory, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA
    • Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
    • ,
  • John A. Kellum, MD

      Affiliations

    • Clinical Research, Investigation, and Systems Modeling of Acute Illness Laboratory, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA
    • ,
  • Donald M. Yealy, MD

      Affiliations

    • Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA
    • ,
  • Lan Kong, PhD

      Affiliations

    • Clinical Research, Investigation, and Systems Modeling of Acute Illness Laboratory, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA
    • Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
    • ,
  • Michael Martino, MD

      Affiliations

    • Department of Emergency Medicine, Jefferson Regional Medical Center, Pittsburgh, PA.
    • ,
  • Derek C. Angus, MD, MPH

      Affiliations

    • Clinical Research, Investigation, and Systems Modeling of Acute Illness Laboratory, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA
    • ,
  • GenIMS Investigators

Received 23 October 2007 ,Revised 21 December 2007 ,Accepted 8 January 2008.

  • Image Result

    Flow diagram of study. Gen IMS, Genetic and Inflammatory Markers of Sepsis study.

    Flow diagram of study. Gen IMS, Genetic and Inflammatory Markers of Sepsis study.

  • Image Result

    Kaplan-Meier survival curves, by Pneumonia Severity Index class and procalcitonin tier. In Pneumonia Severity Index classes I to III, mortality was low, and stratification by procalcitonin tier did no

    Kaplan-Meier survival curves, by Pneumonia Severity Index class and procalcitonin tier. In Pneumonia Severity Index classes I to III, mortality was low, and stratification by procalcitonin tier did not provide additional information. In Pneumonia Severity Index classes IV/V, patients with a procalcitonin level less than 0.1 ng/mL had the lowest 30-day mortality. PCT, Procalcitonin.

  • Image Result
    Kaplan-Meier survival curves, by CURB-65 group and procalcitonin tier. In CURB-65 group 1 patients, mortality was low, and stratification by procalcitonin tier did not provide additional information.

    Kaplan-Meier survival curves, by CURB-65 group and procalcitonin tier. In CURB-65 group 1 patients, mortality was low, and stratification by procalcitonin tier did not provide additional information. In CURB-65 groups 2/3, patients with a procalcitonin level less than 0.1 ng/mL had the lowest 30-day mortality.

 Supervising editors: Gregory J. Moran, MD; Judd E. Hollander, MD

 Dr. Moran and Dr. Hollander were the supervising editors on this article. Dr. Yealy did not participate in the editorial review or decision to publish this article.

 Author contributions: DTH, LAW, JAK, DMY, and DCA conceived and designed the study, analyzed and interpreted the data, and provided important critical revisions of the article. DTH, DMY and DCA drafted the article. DTH, JAK, DMY, and DCA provided final approval. LAW and LK provided statistical expertise. LAW also contributed to drafting of the article, and LK contributed to analysis and interpretation of the data. JAK and DCA obtained funding for the study. JAK, MM, and DCA provided administrative, technical, and logistic support. MM also contributed to analysis and interpretation of the data and article revision. DTH takes responsibility for the paper as a whole.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article, that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. Funding received from: NIGMS R01 GM061992. DTH, LAW, LK, DCA have provided consulting work to BRAHMS Diagnostica, the manufacturer of the procalcitonin assay used in this study. DTH has received one speaking honorarium and travel expenses for presentation at a satellite symposium of the September 2006 European Respiratory Society meeting in Munich, Germany. BRAHMS Diagnostica covered sample shipping and procalcitonin assay costs; no direct monetary grant support was provided.

 Publication dates: Available online March 17, 2008.

 Reprints not available from the authors.

PII: S0196-0644(08)00030-9

doi: 10.1016/j.annemergmed.2008.01.003

Annals of Emergency Medicine
Volume 52, Issue 1 , Pages 48-58.e2 , July 2008

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