Clinical significance of procalcitonin level in elderly patients with heart failure and pneumonia
Received:October 18, 2018  
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DOI:10.11915/j.issn.1671-5403.2019.02.023
Key words:aged; serum procalcitonin; heart failure; pneumonia
Author NameAffiliationE-mail
BAO Xiao-Mei Department of Cardiology, Shanghai Xuhui Central Hospital, Shanghai 200031, China baoxiaomei_nt@sina.cn 
ZHENG Hong-Chao Department of Cardiology, Shanghai Xuhui Central Hospital, Shanghai 200031, China  
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Abstract:
      Objective To explore the clinical significance of the serum level of procalcitonin (PCT) in assessment of infection severity and prognosis in the elderly patients with heart failure (HF) and pneumonia. Methods A total of 206 HF elderly patients (over 65 years old), who admitted to our hospital from February 2016 to February 2018 were enrolled in this study. They were assigned into HF plus pneumonia group (HF+P, n=156) and merely heart failure group (HF, n=50). Another 25 simple pneumonia inpatients in our department during the same period were randomly recruited and served as positive control group (P). Serum PCT levels of all the subjects were detected and compared among the 3 groups. For the patients of the HF+P group, they were further divided into 4 groups according to the serum PCT level, that is, <0.5,0.5≤PCT<2.0,2.0≤PCT<5.0 and ≥5.0 μg/L subgroups. The utilization ratio and time of intravenous antibiotic, length of hospital stay, incidence rate of multiple organ dysfunction syndrome (MODS), mortality and bacterial infection rate of these patients were recorded and analyzed. SPSS statistics 19.0 was used for data analysis. According to the data type, one-way analysis of variance, LSD-t test or Chi-square test was used for comparison among groups. Receiver operating characteristic (ROC) curve analysis was preformed to analyze the diagnostic effect of PCT on HT+P. Results The serum PCT level was (2.210±1.014)μg/L in the HF+P group, significantly higher than that of the HF group [(0.120±0.097)μg/L, t=13.583, P=0.000] and the P group [(1.031±0.425)μg/L, t=6.732, P=0.000]. The cut-off value of PCT was 0.32 μg/L in the diagnosis of HF+P for the elderly, with a sensitivity of 87.8% and a specificity of 96.0%. The positive and negative predictive values were 98.56%(137/139) and 71.64%(48/67), respectively. With the increase of serum PCT level in the HF+P group, the [JP+2]utilization ratio and time of intravenous antibiotic, length of hospital stay, morbidity of MODS, mortality and bacterial infection rate were increased significantly (P<0.05). Conclusion The serum PCT level has clinical values in assessment of infection severity, guiding the treatment of antibiotics, and evaluating the prognosis in the elderly HF+P patients.
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