PROGNOSTIC ROLE OF PROCALCITONIN AND C-REACTIVE PROTEIN IN HOSPITAL ACQUIRED PNEUMONIA IN THE INTENSIVE CARE UNIT

1. 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

2. Aim • Procalcitonin (PCT), is a precursor of calcitonin and it is a better marker than other infection markers for the prognosis and monitoring the response to the therapy • We aimed to asses the prognostic role of PCT in the ICU patients who developed nosocomial pneumonia and compare it with CRP TANRIVERDİ 2009

3. Material and method • Patients who admitted to Zonguldak Karaelmas University Faculty of Medicine Hospital ICUs with the diagnosis of other than pneumonia and who developed Hospital associated pneumonia or ventilatory associated pneumonia (VAP) were included the study • We obtained blood samples for PCT and CRP on the day of pneumonia diagnosis, 3rd and 7th of therapy and clinical features of patients were assesed TANRIVERDİ 2009

4. Diagnostic criterias of pneumonia • New or persistent infiltrate on chest radiography and at least two of followings 1. Body temperature >38 °C or < 36°C 2. Leukocyte count (>11,000 ) or <4.000 ) 3. Purulant secretion • ETA 100.000 cfu/ml was considered as positive culture TANRIVERDİ 2009

5. Patients followed 28 days after diagnosis. • Patients who died before 28th day called as Group 1 and patients who lived until 28th day or discharged called as Group 2 • We used SPSS 11.0 for Statistical analyse TANRIVERDİ 2009

6. Features of patients included the study • 45 cases • Mean age 64±16 (range 19 -87) • 33 (73,3%) VAP • 12 (26,7%) HAP • Gruop 1: 22 (48,9%) (who died before 28th day) • Gruop 2: 23 (51,1%) TANRIVERDİ 2009

7. TANRIVERDİ 2009 *P<0,05

8. TANRIVERDİ 2009

9. TANRIVERDİ 2009

10. TANRIVERDİ 2009

11. TANRIVERDİ 2009

12. There was no significant difference between two groups for PCT and CRP values Outcome Outcome TANRIVERDİ 2009

13. Yaşayan hastalarla eksitus olan hastalar arasında 3. ve 7. günlerde bakılan PCT düzeyleri arasında istatistiksel olarak anlamlı fark saptandı (p<0.001). Outcome Outcome TANRIVERDİ 2009

14. 1, 3 ve 7. günlerde bakılan CRP düzeyleri açısından ise iki grup arasında istatistiksel olarak anlamlı fark saptanmadı. Outcome Outcome TANRIVERDİ 2009

15. TANRIVERDİ 2009

16. TANRIVERDİ 2009

17. TANRIVERDİ 2009

18. TANRIVERDİ 2009

19. Conclusion • PCT, is a better marker than CRP for the prognosis of HAP • Differences in the PCT values can be used for the prediction of prognosis • Decreasing levels of PCT is a finding that shows improvement of infectious clinic • İncreasing levels of PCT should be considered as a poor prognostic sign TANRIVERDİ 2009

20. 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 CID 2004:39 (15 July) • Simon et al. TANRIVERDİ 2009

21. Teşekkürler TANRIVERDİ 2009