ArticleBMC geriatrics2016
The association of serum procalcitonin and high-sensitivity C-reactive protein with pneumonia in elderly multimorbid patients with respiratory symptoms: retrospective cohort study.
Article in BMC geriatrics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 citations in OpenAlex.
- Biomarkers as point-of-care tests to guide prescription of antibiotics in people with acute respiratory infections in primary care.The Cochrane database of systematic reviews · 2022Pooled it
- Effect of C reactive protein point-of-care testing on antibiotic prescribing for lower respiratory tract infections in nursing home residents: cluster randomised controlled trial.BMJ (Clinical research ed.) · 2021Trial
- Nomogram for predicting 28-day mortality in bacterial pneumonia with sepsis and acute kidney injury: A study based on the Medical Information Mart for Intensive Care-IV database.SAGE open medicine · 2026Article
- Association between serial changes in serum C-reactive protein levels and mortality among patients with pleural empyema: a database research.BMC pulmonary medicine · 2025Article
- An Analysis of Bacterial Infection Distribution in the Elderly, and Their Clinical and Laboratory Profiles: Aging and Bacterial Infection.Infectious diseases & clinical microbiology · 2025Article
- Metabolic Disturbances Associated with In-Hospital Complication and Mortality in Different Types of Pneumonia.Journal of clinical medicine · 2024Article
- A Review on Risk Factors, Traditional Diagnostic Techniques, and Biomarkers for Pneumonia Prognostication and Management in Diabetic Patients.Diseases (Basel, Switzerland) · 2024Review
- Emergency department patient and physician survey accuracy compared to chart abstraction in patients with acute respiratory illness.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2023Article
- Preparing of Point-of-Care Reagents for Risk Assessment in the Elderly at Home by a Home-Visit Nurse and Verification of Their Analytical Accuracy.Diagnostics (Basel, Switzerland) · 2023Article
- Diagnostic and Prognostic Roles of Procalcitonin and Other Tools in Community-Acquired Pneumonia: A Narrative Review.Diagnostics (Basel, Switzerland) · 2023Review
- Article
- Association between anesthesia technique and complications after hip surgery in the elderly population.World journal of clinical cases · 2022Article
- Early warning of bloodstream infection in elderly patients with circulating microparticles.Annals of intensive care · 2021Article
- Diagnosing Dyspneic Older Adult Emergency Department Patients: A Pilot Study.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2021Article
- The Clinical Significance of Procalcitonin Elevation in Patients over 75 Years Old Admitted for COVID-19 Pneumonia.Mediators of inflammation · 2021Article
- Community-acquired pneumonia in critically ill very old patients: a growing problem.European respiratory review : an official journal of the European Respiratory Society · 2020Review
- Using point-of-care C-reactive protein to guide antibiotic prescribing for lower respiratory tract infections in elderly nursing home residents (UPCARE): study design of a cluster randomized controlled trial.BMC health services research · 2020Article
- Observational
- Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital.BMC geriatrics · 2019Article
- The moderate predictive value of serial serum CRP and PCT levels for the prognosis of hospitalized community-acquired pneumonia.Respiratory research · 2018Observational
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSerum procalcitonin and high-sensitivity C-reactive protein (hs-CRP) elevations have been associated with pneumonia in adults. Our aim was to establish their diagnostic usefulness in a cohort of hospitalized multimorbid patients ≥65 years old admitted to hospital with acute respiratory symptoms.
methodsWith a retrospective cohort study design, all multimorbid patients ≥65 years-old with acute respiratory symptoms admitted to an internal medicine hospital ward in Italy from January to August 2013 were evaluated. Pneumonia diagnosis, comorbidities expressed through Cumulative Illness Rating Scale (CIRS), setting of living, length of stay, serum hs-CRP and procalcitonin at admission were collected for each patient. Data were analyzed with Mann-Whitney's U test and multivariate Cox logistic regression analysis. A Receiver Operating Characteristic (ROC) curve was used to verify each biomarker's association with pneumonia diagnosis.
resultsFour hundred fifty five patients (227 M) were included in the study, of whom 239 with pneumonia (138 M, mean age 80 ± 13) and 216 without pneumonia (89 M, mean age 80 ± 14). After adjustment for age and sex, median levels of hs-CRP were significantly higher in patients with pneumonia (116 mg/L, IQR 46.5-179.0, vs 22.5 mg/dl, IQR 6.9-84.4, p < 0.0001), while procalcitonin median levels were not (0.22 ng/ml IQR 0.12-0.87, vs 0.15 ng/ml, IQR 0.10-0.35, p = 0.08). The ROC analysis showed that, unlike procalcitonin, hs-CRP values were predictive of pneumonia (AUC 0.76, 95% CI 0.72-0.79, p < 0.0001, cut-off value 61 mg/L), even after adjustment for possible confounders including nursing home residence and dementia. Serum hs-CRP levels >61 mg/L were independently associated with a 3.59-fold increased risk of pneumonia (OR 3.59, 95% CI 2.35-5.48, p < 0.0001).
conclusionIn elderly multimorbid patients who require hospital admission for respiratory symptoms, serum hs-CRP testing seems to be more useful than procalcitonin for guiding the diagnostic process when clinical suspicion of pneumonia is present. Procalcitonin testing might hence be not recommended in this setting.
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