Role of Procalcitonin as prognostic factors in COPD exacerbation
Rammaert et al studied the effects of Procalcitonin as a prognostic factor in severe acute exacerbation of chronic obstructive pulmonary disease. A prospective observational cohort study was conducted of 116 consecutive patients with severe acute exacerbation of COPD requiring intubation and mechanical ventilation with their mean age being 67 years and mean simplified physiological score was 43.
Results: Sixty-five per cent of patients had chronic respiratory insufficiency.
- Logistic organ dysfunction score (hazard ratio (95% CI) = 1.19 (1.03–1.37), P = 0.013), rapidly fatal underlying disease (3.33 (1.40–7.87), P = 0.003) and procalcitonin level (1.01 (1–1.03), P = 0.018) were independently associated with increased risk for ICU mortality.
- Non-invasive mechanical ventilation use before intubation was independently associated with reduced risk for ICU mortality (0.34 (0.14–0.84), P = 0.020).
Conclusions:
In patients with severe acute exacerbation of COPD requiring intubation and mechanical ventilation, logistic organ dysfunction score, rapidly fatal underlying disease and procalcitonin are independently associated with increased risk for ICU mortality.
Non-invasive mechanical ventilation use before intubation was independently associated with reduced risk for ICU mortality.
Reference:
Rammaert B, Verdier N, Cavestri B, Nseir S. Procalcitonin as a prognostic factor in severe acute exacerbation of chronic obstructive pulmonary disease. Respirology 2009; Published online July 30 2009.
