ArticleAnnals of emergency medicine2008
Risk prediction with procalcitonin and clinical rules in community-acquired pneumonia.
Article in Annals of emergency medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 72 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Procalcitonin Antibiotic Consensus Trial (ProACT)
Procalcitonin at Zero and 24 Hours as a Prognostic Factor in Patients With Pneumonia
Who cites it
72 citing papers in PubMed, 7 syntheses or guidelines pooled it, 212 citations in OpenAlex.
- Prognostic value of procalcitonin in pneumonia: A systematic review and meta-analysis.Respirology (Carlton, Vic.) · 2016Pooled it
- Systematic review regarding metabolic profiling for improved pathophysiological understanding of disease and outcome prediction in respiratory infections.Respiratory research · 2015Pooled it
- Prognostic value of procalcitonin in respiratory tract infections across clinical settings.Critical care (London, England) · 2015Pooled it
- Prognostic Value of Procalcitonin in Adult Patients with Sepsis: A Systematic Review and Meta-Analysis.PloS one · 2015Pooled it
- Risk prediction models for mortality in community-acquired pneumonia: a systematic review.BioMed research international · 2013Pooled it
- Guidelines for the management of adult lower respiratory tract infections--full version.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2011Guideline
- Validity of British Thoracic Society guidance (the CRB-65 rule) for predicting the severity of pneumonia in general practice: systematic review and meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Pooled it
- Procalcitonin-Guided Use of Antibiotics for Lower Respiratory Tract Infection.The New England journal of medicine · 2018Trial
- Biomarker-enhanced triage in respiratory infections: a proof-of-concept feasibility trial.The European respiratory journal · 2013Trial
- Trial
- Accuracy of C-reactive protein, procalcitonin, and mid-regional pro-atrial natriuretic peptide to guide site of care of community-acquired pneumonia.Intensive care medicine · 2010Trial
- Baseline Predictors of Adverse Outcome and Survival in Adults Hospitalized with Invasive Pneumococcal Disease.Healthcare (Basel, Switzerland) · 2026Article
- ERS/ESCMID state-of-the-science statement on the role of rapid diagnostic tests for the diagnosis and management of community-acquired lower respiratory tract infections.The European respiratory journal · 2026Review
- Relationship between eosinopenia and neutrophil-lymphocyte ratio with sepsis-related mortality in the intensive care unit.Caspian journal of internal medicine · 2025Article
- The role of CTGF and MFG-E8 in the prognosis assessment of SCAP: a study combining machine learning and nomogram analysis.Frontiers in immunology · 2025Article
- Article
- Severe community-acquired pneumonia.European respiratory review : an official journal of the European Respiratory Society · 2022Review
- A biomarker assay to risk-stratify patients with symptoms of respiratory tract infection.The European respiratory journal · 2022Article
- A literature review of severity scores for adults with influenza or community-acquired pneumonia - implications for influenza vaccines and therapeutics.Human vaccines & immunotherapeutics · 2021Review
- Recommendations for antibiotic selection for severe nosocomial infections.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2021Article
12 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
STUDY
objectiveThe Pneumonia Severity Index and CURB-65 predict outcomes in community-acquired pneumonia but have limitations. Procalcitonin, a biomarker of bacterial infection, may provide prognostic information in community-acquired pneumonia. Our objective is to describe the pattern of procalcitonin in community-acquired pneumonia and determine whether procalcitonin provides prognostic information beyond the Pneumonia Severity Index and CURB-65.
methodsWe conducted a multicenter prospective cohort study in 28 community and teaching emergency departments. Patients presenting with a clinical and radiographic diagnosis of community-acquired pneumonia were enrolled. We stratified procalcitonin levels a priori into 4 tiers: I: less than 0.1; II: greater than 0.1 to less than 0.25; III: greater than 0.25 to less than 0.5; and IV: greater than 0.5 ng/mL. Primary outcome was 30-day mortality.
resultsOne thousand six hundred fifty-one patients formed the study cohort. Procalcitonin levels were broadly spread across tiers: 32.8% (I), 21.6% (II), 10.2% (III), and 35.4% (IV). Used alone, procalcitonin had modest test characteristics: specificity (35%), sensitivity (92%), positive likelihood ratio (1.41), and negative likelihood ratio (0.22). Adding procalcitonin to the Pneumonia Severity Index in all subjects minimally improved performance. Adding procalcitonin to low-risk Pneumonia Severity Index subjects (classes I to III) provided no additional information. However, subjects in procalcitonin tier I had low 30-day mortality, regardless of clinical risk, including those in higher risk classes (1.5% versus 1.6% for those in Pneumonia Severity Index classes I to III versus classes IV/V). Among high-risk Pneumonia Severity Index subjects (classes IV/V), one quarter (126/546) were in procalcitonin tier I, and the negative likelihood ratio of procalcitonin tier I was 0.09. Procalcitonin tier I was also associated with lower burden of other adverse outcomes. Similar results were observed with CURB-65 stratification.
conclusionSelective use of procalcitonin as an adjunct to existing rules may offer additional prognostic information in high-risk patients.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.