RT Journal Article SR Electronic T1 Prognostic value of procalcitonin in community-acquired pneumonia JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP erj00356-2010 DO 10.1183/09031936.00035610 A1 P. Schuetz A1 I. Widmer A1 A. Chaudri A1 M. Christ-Crain A1 W. Zimmerli A1 B. Mueller YR 2010 UL http://erj.ersjournals.com/content/early/2010/07/01/09031936.00035610.abstract AB The prognostic value of procalcitonin levels to predict mortality and other adverse events in community-acquired pneumonia (CAP) remains undefined.We assessed the performance of procalcitonin overall, stratified into four predefined procalcitonin tiers (<0.1,0.1–0.25,0.25–0.5,>0.5μg·L−1) and stratified by pneumonia-severity-index (PSI) and CURB65 risk classes to predict all-cause mortality and adverse events within 30 days follow-up in 925 CAP patients.In receiver-operating-curves (ROC), initial procalcitonin levels performed only moderately for mortality prediction (area-under-the-curve (AUC) 0.60) and did not improve clinical risk scores. Follow-up measurements on days three, five and seven showed better prognostic performance (AUCs 0.61, 0.68 and 0.73). For prediction of adverse events, the AUC was 0.66 and PCT significantly improved the PSI (from 0.67 to 0.71) and the CURB65 (from 0.64 to 0.70). In Kaplan-Meier-curves, procalcitonin tiers significantly separated patients within PSI and CURB65 risk classes for adverse events prediction, but not for mortality. Reclassification analysis confirmed the added value of PCT for adverse event prediction, but not mortality.Initial procalcitonin levels provide only moderate prognostic information concerning mortality risk and did not improve clinical risk scores. However, procalcitonin was helpful during follow-up and for prediction of adverse events and thereby improved the PSI and CURB65 scores.