Evidence map›Paper›PMID 25926728›Full record

ArticleInternational journal of chronic obstructive pulmonary disease2015

Procalcitonin and C-reactive protein cannot differentiate bacterial or viral infection in COPD exacerbation requiring emergency department visits.

Chih-Hao Chang, Kuo-Chien Tsao, Han-Chung Hu, Chung-Chi Huang, Kuo-Chin Kao, Ning-Hung Chen, Cheng-Ta Yang, Ying-Huang Tsai, Meng-Jer Hsieh

Open access · goldAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of chronic obstructive pulmonary disease, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 3 pooled it
3.3field-weighted citation impact, top 7% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 40 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Procalcitonin to guide antibiotic administration in COPD exacerbations: a meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2017
    Pooled it
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  19. Respiratory viral infections in the elderly.Therapeutic advances in respiratory disease
    Review
  20. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Chih-Hao ChangDepartment of Pulmonary and Critical Care Medicine, Linkou Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Chang-Gung University College of Medicine, Taoyuan, Taiwan.
Kuo-Chien TsaoDepartment of Laboratory Medicine, Linkou Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Taoyuan, Taiwan ; Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan.
Han-Chung HuDepartment of Pulmonary and Critical Care Medicine, Linkou Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Chang-Gung University College of Medicine, Taoyuan, Taiwan ; Department of Respiratory Therapy, Chang-Gung University, Taoyuan, Taiwan.
Chung-Chi HuangDepartment of Pulmonary and Critical Care Medicine, Linkou Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Chang-Gung University College of Medicine, Taoyuan, Taiwan ; Department of Respiratory Therapy, Chang-Gung University, Taoyuan, Taiwan.
Kuo-Chin KaoDepartment of Pulmonary and Critical Care Medicine, Linkou Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Chang-Gung University College of Medicine, Taoyuan, Taiwan ; Department of Respiratory Therapy, Chang-Gung University, Taoyuan, Taiwan.
Ning-Hung ChenDepartment of Pulmonary and Critical Care Medicine, Linkou Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Chang-Gung University College of Medicine, Taoyuan, Taiwan ; Department of Respiratory Therapy, Chang-Gung University, Taoyuan, Taiwan.
Cheng-Ta YangDepartment of Pulmonary and Critical Care Medicine, Linkou Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Chang-Gung University College of Medicine, Taoyuan, Taiwan ; Department of Respiratory Therapy, Chang-Gung University, Taoyuan, Taiwan.
Ying-Huang TsaiDepartment of Respiratory Therapy, Chang-Gung University, Taoyuan, Taiwan ; Department of Pulmonary and Critical Care Medicine, Chiayi Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Puzi City, Taiwan.
Meng-Jer HsiehDepartment of Respiratory Therapy, Chang-Gung University, Taoyuan, Taiwan ; Department of Pulmonary and Critical Care Medicine, Chiayi Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Puzi City, Taiwan.
Chang Gung University · TWChang Gung Memorial Hospital · TWChiayi Chang Gung Memorial Hospital · TWLinkou Chang Gung Memorial Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundViral and bacterial infections are the most common causes of chronic obstructive pulmonary disease (COPD) exacerbations. Whether serum inflammatory markers can differentiate bacterial from virus infection in patients with COPD exacerbation requiring emergency department (ED) visits remains controversial.

methodsViral culture and polymerase chain reaction (PCR) were used to identify the viruses in the oropharynx of patients with COPD exacerbations. The bacteria were identified by the semiquantitative culture of the expectorated sputum. The peripheral blood white blood cell (WBC) counts, serum C-reactive protein (CRP), procalcitonin (PCT), and clinical symptoms were compared among patients with different types of infections.

resultsViruses were isolated from 16 (22.2%) of the 72 patients enrolled. The most commonly identified viruses were parainfluenza type 3, influenza A, and rhinovirus. A total of 30 (41.7%) patients had positive bacterial cultures, with the most commonly found bacteria being Haemophilus influenzae and Haemophilus parainfluenzae. Five patients (6.9%) had both positive sputum cultures and virus identification. The WBC, CRP, and PCT levels of the bacteria-positive and bacteria-negative groups were not statistically different. Multivariate analysis showed that patients with increased sputum volumes during the COPD exacerbations had higher risks of recurrent exacerbations in the 1-year period following the first exacerbation.

conclusionWBC, CRP, or PCT could not differentiate between bacterial and viral infections in patients with COPD exacerbation requiring ED visits. Those with increased sputum during a COPD exacerbation had higher risks for recurrent exacerbations.

Indexed as

Emergency Service, HospitalAgedAged, 80 and overBiomarkersCalcitoninCalcitonin Gene-Related PeptideChi-Square DistributionC-Reactive ProteinDiagnosis, DifferentialDisease ProgressionFemaleHumansInflammation MediatorsKaplan-Meier EstimateLeukocyte CountMaleBiomarkersCALCA protein, humanCalcitoninCalcitonin Gene-Related PeptideC-Reactive ProteinInflammation MediatorsProtein Precursorsbacterial infectionchronic obstructive pulmonary diseaseCRPvirus

Identifiers

PMID25926728
PMCPMC4403815
OpenAlexW2084494795

What OpenQuestion holds

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Registered trials

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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.