Introduction/Hypothesis: This study aimed to assess the predictive value of initial procalcitonin level for bacteremia in patients with pneumonia in the emergency department (ED). Methods: This study was a single-center,… Click to show full abstract
Introduction/Hypothesis: This study aimed to assess the predictive value of initial procalcitonin level for bacteremia in patients with pneumonia in the emergency department (ED). Methods: This study was a single-center, retrospective study conducted from January 2016 to June 2018. Serum procalcitonin and blood cultures were obtained from adult patients with pneumonia in the ED. We categorized the patients into either the bacteremia group or the non-bacteremia group, according to the results of blood cultures. We compared procalcitonin level between bacteremia group and non-bacteremia group. The area under the receiver operating curve (AUROC) of procalcitonin was calculated for predicting bacteremia. Results: A total of 934 patients were analyzed. Of the eligible patients, we assigned 902(96.6%) patients to the non-bacteremia group and 32 (3.4%) patients to the bacteremia group. Procalcitonin level was significantly higher in the bacteremia group compared to the non-bacteremia group (5.06 ng/mL;IQR, 1.8815.78 vs 0.29 ng/mL; IQR, 0.12-1.01: p<0.001). The AUROC of procalcitonin was 0.819 (95% CI, 0.734-904). Conclusions: We found that the initial procalcitonin level may be useful to predict bacteremia in patients with pneumonia in the ED. Not only in community-acquired pneumonia patients but also hospital-acquired pneumonia and healthcare-acquired pneumonia patients, procalcitonin was more sensitive and predictive of bacteremia than other laboratory tests.
               
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