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Likelihood Ratio (LR) in Emergency Medicine

5/14/2013

PCT and pneumonia: worth it?


Clinical Scenario

A 78 yo woman is brought from an assisted-living facility because of dyspnea and fever. 
She has an history of dyabetes and heart failure. She is confused, tachipnoic, tachicardic and febrile with rales on the back. Chest X ray shows an infiltrate. PCT value is 1,5 µg/L. 



Does PCT provide prognostic information concerning mortality risk or adverse event in pneumonia? 













Conclusion 

Both risks score (PSI and CURB-65) developed for the patient discusses above are high. The patient has an high risk for mortality and adverse event. The performance of PCT on admission predicting bad events for a patient with pneumonia is very poor. 

It’s time to stop PCT for pneumonia?



Bibliography 

P.Schuetz 
Prognostic value of procalcitonin in community-acquired pneumonia.
Eur Respir J 2011 vol 37 pagg 384-392


Ciro Paolillo



….to be continued

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