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응급실에서 진단된 폐렴 환자에서 혈청 프로칼시토닌의 균혈증 예측 능력

Predictive value of procalcitonin for bacteremia in patients with pneumonia in the emergency department

대한응급의학회지 2019년 30권 5호 p.411 ~ 418
이상훈 ( Lee Sang-Hoon ) - 성균관대학교 의과대학 삼성서울병원 응급의학과

박주현 ( Park Joo-Hyun ) - 성균관대학교 의과대학 삼성서울병원 응급의학과

Abstract


Objective: This study examined the predictive value of the initial procalcitonin level for bacteremia in patients with pneumonia in the emergency department (ED).

Method: This study was a single-center, retrospective study conducted from January 2016 to June 2018. The serum procalcitonin and blood cultures were obtained from adult patients with pneumonia in the ED. The patients were categorized into either the bacteremia group or non-bacteremia group, according to the results of the blood cultures. The procalcitonin level in the bacteremia group and non-bacteremia group was compared. The area under the receiver operating curve (AUROC) of procalcitonin was calculated to predict bacteremia.

Results: A total of 934 patients were analyzed. Of the eligible patients, 902 patients (96.6%) and 32 patients (3.4%) were assigned to the non-bacteremia group and bacteremia group, respectively. The procalcitonin level was significantly higher in the bacteremia group than the non-bacteremia group (5.06 ng/mL; interquartile range [IQR], 1.88-15.78 vs. 0.29 ng/mL; IQR, 0.12-1.01: P<0.001). The AUROC of procalcitonin was 0.819 (95% confidence interval, 0.734-0.904).

Conclusion: The initial procalcitonin level might be useful for predicting bacteremia in patients with pneumonia in the ED.

키워드

Pneumonia; Procalcitonin; Blood culture; Bacteremia
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