PROGNOSTIC ROLE OF PROCALCITONIN PROGNOSTIC ROLE OF PROCALCITONIN AND C-REACTIVE PROTEIN IN HOSPITAL AND C-REACTIVE PROTEIN IN HOSPITAL ACQUIRED PNEUMONIA IN THE ACQUIRED PNEUMONIA IN THE INTENSIVE CARE UNIT INTENSIVE CARE UNIT HAKAN TANRIVERDİ HAKAN TANRIVERDİ , MELTEM TOR, OLGUN KESKİN, , MELTEM TOR, OLGUN KESKİN, FIRAT UYGUR, VİLDAN SÜMBÜLOĞLU*, CEVAHİR FIRAT UYGUR, VİLDAN SÜMBÜLOĞLU*, CEVAHİR ÇELİK ÇELİK Zonguldak Karaelmas University Faculty of Zonguldak Karaelmas University Faculty of Medicine Medicine Chest Diseases, *Biostatistic Chest Diseases, *Biostatistic
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PROGNOSTIC ROLE OF PROCALCITONIN AND C-REACTIVE PROTEIN IN HOSPITAL ACQUIRED PNEUMONIA IN THE INTENSIVE CARE UNIT
PROGNOSTIC ROLE OF PROCALCITONIN AND C-REACTIVE PROTEIN IN HOSPITAL ACQUIRED PNEUMONIA IN THE INTENSIVE CARE UNIT. HAKAN TANRIVERDİ , MELTEM TOR, OLGUN KESKİN, FIRAT UYGUR, VİLDAN SÜMBÜLOĞLU*, CEVAHİR ÇELİK Zonguldak Karaelmas University Faculty of Medicine Chest Diseases, *Biostatistic. - PowerPoint PPT Presentation
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PROGNOSTIC ROLE OF PROCALCITONIN PROGNOSTIC ROLE OF PROCALCITONIN AND C-REACTIVE PROTEIN IN HOSPITAL AND C-REACTIVE PROTEIN IN HOSPITAL
ACQUIRED PNEUMONIA IN THE INTENSIVE ACQUIRED PNEUMONIA IN THE INTENSIVE CARE UNITCARE UNIT
Zonguldak Karaelmas University Faculty of Medicine Zonguldak Karaelmas University Faculty of Medicine Chest Diseases, *BiostatisticChest Diseases, *Biostatistic
AimAim Procalcitonin (PCT), is a precursor of calcitonin Procalcitonin (PCT), is a precursor of calcitonin
and it is a better marker than other infection and it is a better marker than other infection markers for the prognosis and monitoring the markers for the prognosis and monitoring the response to the therapyresponse to the therapy
We aimed to asses the prognostic role of PCT in We aimed to asses the prognostic role of PCT in the ICU patients who developed nosocomial the ICU patients who developed nosocomial pneumonia and compare it with CRPpneumonia and compare it with CRP
TANRIVERDİ 2009
Material and methodMaterial and method Patients who admitted to Zonguldak Karaelmas Patients who admitted to Zonguldak Karaelmas
University Faculty of Medicine Hospital ICUs with University Faculty of Medicine Hospital ICUs with the diagnosis of other than pneumonia and who the diagnosis of other than pneumonia and who developed Hospital associated pneumonia or developed Hospital associated pneumonia or ventilatory associated pneumonia (VAP) were ventilatory associated pneumonia (VAP) were included the studyincluded the study
We obtained blood samples for PCT and CRP on We obtained blood samples for PCT and CRP on the day of pneumonia diagnosis, 3rd and 7th of the day of pneumonia diagnosis, 3rd and 7th of therapy and clinical features of patients were therapy and clinical features of patients were assesed assesed
TANRIVERDİ 2009
Diagnostic criterias of Diagnostic criterias of pneumoniapneumonia
New or persistent infiltrate on chest New or persistent infiltrate on chest radiography and at least two of followings radiography and at least two of followings
1. Body temperature >38 °C or < 36°C1. Body temperature >38 °C or < 36°C2. Leukocyte count (>11,000 ) or <4.000 ) 2. Leukocyte count (>11,000 ) or <4.000 ) 3. Purulant secretion3. Purulant secretion ETA 100.000 cfu/ml was considered as ETA 100.000 cfu/ml was considered as
positive culturepositive culture
TANRIVERDİ 2009
Patients followed 28 days after diagnosis.Patients followed 28 days after diagnosis. Patients who died before 28th day called Patients who died before 28th day called
as as Group 1Group 1 and patients who lived until and patients who lived until 28th day or discharged called as 28th day or discharged called as Group 2Group 2
We used SPSS 11.0 for Statistical analyseWe used SPSS 11.0 for Statistical analyse
TANRIVERDİ 2009
Features of patients included the Features of patients included the studystudy
45 cases45 cases Mean age 64±16 (range 19 -87)Mean age 64±16 (range 19 -87) 33 (73,3%) VAP33 (73,3%) VAP 12 (26,7%) HAP 12 (26,7%) HAP Gruop 1:Gruop 1: 22 (48,9%) (who died before 22 (48,9%) (who died before
There was no significant difference between two There was no significant difference between two groups for PCT and CRP valuesgroups for PCT and CRP values
OutcoOutcome me
OutcoOutcome me
TANRIVERDİ 2009
Yaşayan hastalarla eksitus olan hastalar Yaşayan hastalarla eksitus olan hastalar arasında 3. ve 7. günlerde bakılan PCT arasında 3. ve 7. günlerde bakılan PCT
düzeyleri arasında istatistiksel olarak anlamlı düzeyleri arasında istatistiksel olarak anlamlı fark saptandı (p<0.001).fark saptandı (p<0.001).
OutcoOutcome me
OutcoOutcome me
TANRIVERDİ 2009
1, 3 ve 7. günlerde bakılan CRP düzeyleri 1, 3 ve 7. günlerde bakılan CRP düzeyleri açısından ise iki grup arasında istatistiksel açısından ise iki grup arasında istatistiksel
olarak anlamlı fark saptanmadı.olarak anlamlı fark saptanmadı.
Conclusion Conclusion PCT, is a better marker than CRP for the PCT, is a better marker than CRP for the
prognosis of HAPprognosis of HAP Differences in the PCT values can be used Differences in the PCT values can be used
for the prediction of prognosisfor the prediction of prognosis Decreasing levels of PCT is a finding that Decreasing levels of PCT is a finding that
shows improvement of infectious clinicshows improvement of infectious clinic İncreasing levels of PCT should be İncreasing levels of PCT should be
considered as a poor prognostic sign considered as a poor prognostic sign
TANRIVERDİ 2009
Overall accuracy of PCT markers is higher than that of CRP markers both to differentiate bacterial infections from viral infections and to differentiate bacterial infections from other noninfective causes of systemic inflammation
Serum Procalcitonin and C-Reactive Protein Levels as Markers of Bacterial Infection: A Systematic Review and Meta-analysis